• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.12-12
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• 1982

We have recently experienced a case of decannulation difficulty resulted from head and thoracic injury. The patient was 21-year-old male who undergone craniectomy and tracheotomy at other hospital about 7 months ago prior to admission On admission, there was swelling in glottic and subglottic region in indirect laryngoscopy and bronchoscopy with fixation of vocal cords in paramedian position. We tried to reestablish an adequate air way with bougination using Jackson esophageal bougie but there was no effect with it. So we performed vertical incision through cricoid cartilage and tracheal rings and insertion of Teflon tube in stenotic lesion for 9 months and removed it. At present time, the patient has been satisfactory corking training course.

• Phonetics and Speech Sciences
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• v.9 no.3
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• pp.85-91
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• 2017

The present study aimed to investigate the changes of acoustic parameters of the aspirated voice in stroke patients. The eighty-eight subjects diagnosed with cerebro-vascular accident were divided into 32 penetration/aspiration (P/A) and 56 Non-P/A groups according to the videofluroscopic swallowing study (VFSS) results, and 26 control subjects participated. All subjects preformed VFSS and vowel /a/ was recorded three times pre- and post VFSS. Since the variation in the acoustic parameters within a single phonation has been observed, we proposed a delta formula for the acoustic parameters which can reflect the temporal changes of the each parameter in an utterance. We measured from the voice data eight acoustic parameters: fundamental frequency (F0), standard deviation of F0 (F0_SD), Jitter, relative average perturbation (RAP), Shimmer, amplitude perturbation quotient (APQ), harmonic to noise ration (HNR), noise to harmonic ratio (NHR). Then we found parameters which show the meaningful biggest temporal change in an utterance using the suggested delta parameter. Among them, the deltas of shimmer and APQ were significantly different pre- and post VFSS. These deltas of the P/A and the control group were increased after VFSS, while those of the Non-P/A group was descended. The variation patterns of the P/A and the control group were similar but the change width of the P/A group was larger. The large variations in an aspirated phonation of the P/A group are thought to be caused by irregular changes in air resistance due to residual food on the vocal cords.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.133-136
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• 2011

Background and Objectives : Previous jet ventilation is not becoming more common because of high price, making loud noise, and causing a movement of the vocal cords due to the jet stream. So we designed a new type of manually controlled jet ventilation using previous laryngoscope and introduced it's clinical application. Materials and Method : A prospective study involved 20 patients all having undergone surgical intervention under new type of manually controlled jet ventilation from June 2009 to January 2011. The prospective study was to assess the vital sign and operative and postoperative complications. Results : The Manually Controlled Jet Ventilation were performed in 20 patients. 50% of the patients have Post-located laryngeal lesion, 20% with tracheal stenosis, 20% with glottic cancer biopsy and laser cordectomy, 10% with postglottic stenosis. Conclusion : Manually Controlled Jet Ventilation (Manujet) can be used for airway surgery.

• Journal of the Korean Society of Fisheries and Ocean Technology
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• v.46 no.4
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• pp.458-465
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• 2010

Hundreds of Steller sea lions, Eumetopias jubatus, migrate from Sakhalin and the northern Kuril Islands to Hokkaido every winter. During this migration, they may use their roaring sounds to navigate and to maintain their groups. We recorded the roars of wild Steller sea lions that had landed on reefs on the west coast of Hokkaido, and those of captive sea lions, while making video recordings. A total of 300 roars of wild sea lions and 870 roars of captive sea lions were sampled. The fundamental frequency ($F_0$), formant frequency ($F_1$), pulse repetition rate (PRR), and duration of syllables (T) were analyzed using a sonagraph. $F_0$, $F_1$, and PRR of the roars emitted by captive sea lions increased in the order male, female, and juvenile. By contrast, the $F_1$ of wild males was lower than that of females, while the $F_0$ and PRR of wild males and females did not differ statistically. Moreover, the $F_0$ and $F_1$ frequencies for captive sea lions were higher than those of wild sea lions, while PRR in captive sea lions was lower than in wild sea lions. Since there was a linear relationship between body length and the $F_0$ and $F_1$ frequencies in captive sea lions, the body length distribution of wild sea lions could be estimated from the $F_0$ and $F_1$ frequency distribution using a regression equation. These results roughly agree with the body length distribution derived from photographic geometry. As the volume of the oral cavity and the length of the vocal cords are generally proportional to body length, sampled roars can provide useful information about a population, such as the body length distribution and sex ratio.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.1
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• pp.32-37
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• 2017

Background and Objectives : This study evaluated the efficacy of combination therapy of proton pump inhibitor (PPI) and steroid inhaler (SI), with or without botulinum toxin injection (BTX) for contact granuloma. Subjects and Methods : Fourteen contact granuloma patients were enrolled in this study. Combination therapy of PPI and SI were used for the first line treatment. When combination therapy was not effective, BTX was performed as the second method. Treatment results were recorded as responsible or non-responsible. Farwell grade, size, history of voice abuse, gender, and reflux finding score (RFS) were compared between responsible group and non-responsible group. Results : Initial response rate was 28.6% after treatment of PPI and SI. BTX was performed on three un-responsible patients. After BTX injection, three patients had complete remission of granuloma. Final response rate was 50.0%. Un-responsible group had significantly higher RFS than responsible group. Conclusion : The efficacy of PPI and SI was limited for contact granuloma in this study. Botulium toxin injection was recommended in early phase when PPI and SI did not effective for contact granuloma. Prospective studies evaluating the effects of PPI and SI are warranted.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.99-103
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• 2014

A laryngeal web is connective tissue covered with epithelium stretching between both sides of the true vocal cords. Laryngeal webs were first reported by Fleischmann in 1882, and they cause upper airway obstruction and abnormalities of phonation. Congenital webs result from an arrest of reabsorption of the epithelium of the larynx at the tenth week of the fetus. The most common site of webbing is the anterior commissural glottic area, followed by other glottic areas and rarely subglottic or supraglottic areas. We have experienced two cases of congenital laryngeal webs. The webs were operated in two different methods. The first was excised under magnified vision through a laryngoscope, with a silastic keel secured between the raw surfaces of the separated mucosa. In the second case, the deepithelialized surfaces were exposed for a certain time length to mitomycin C to prevent postoperative webbing. We, hereby, report our experience of the diagnosis and management of two cases of a rare entity known as the congenital laryngeal web, and discuss the results with relevant studies.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.63-66
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• 2021

Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial circumferential tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.

• Phonetics and Speech Sciences
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• v.10 no.4
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• pp.147-154
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• 2018

Wet voice quality (WVQ) is a characteristic that appears after swallowing. Although the concept is accepted by many clinicians worldwide, it is nevertheless ambiguous. In this study, we investigated WVQ in patients with swallowing disorders using acoustic analysis. A total of 106 patients diagnosed with penetration-aspiration by the videofluoroscopic swallowing study (VFSS) were recruited. A voice recording of vowel /a/ was conducted before and after the VFSS, and an acoustic analysis was then performed using PRAAT. Voice after VFSS was used for a perceptual judgment and divided into two groups: the Wet group (48 patients) and the Non-wet group (58 patients). At the post-VFSS stage, the two groups displayed significant differences in many acoustic parameters including F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP. The parameter affecting judging wetness resulted into Jitter and NHR by the logistic regression test. At the pre-VFSS stage, the two groups differed significantly in many acoustic parameters including Intensity, Jitter, RAP, Shimmer, NHR, FUF, DVB, and CPP. Both pre-and post-VFSS, the mean values of all significant parameters, except Intensity, HNR, and CPP, were higher in the Wet group. According to pre-and post-VFSS, the two groups displayed interactions in many parameters (Intensity, F0_SD, Jitter, RAP, Shimmer, APQ, HNR, NHR, FUF, DVB, and CPP). In particular, Intensity increased in both groups after the VFSS, although the increase in the Non-wet group was greater. Based on these results, it was conjectured that the WVQ after swallowing resulted from the secretion effect of the mucous membrane due to the dry laryngeal characteristic of elderly patients, rather than aspiration resulting in food on the vocal cords.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.110-116
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• 2003

Background and Objectives : Laryngeal cancer discrimination using voice signals is a non-invasive method that can carry out the examination rapidly and simply without giving discomfort to the patients. n appropriate analysis parameters and classifiers are developed, this method can be used effectively in various applications including telemedicine. This study examines voice analysis parameters used for laryngeal disease discrimination to help discriminate laryngeal diseases by voice signal analysis. The study also estimates the laryngeal cancer discrimination activity of the Gaussian mixture model (GMM) classifier based on the statistical modelling of voice analysis parameters. Materials and Methods : The Multi-dimensional voice program (MDVP) parameters, which have been widely used for the analysis of laryngeal cancer voice, sometimes fail to analyze the voice of a laryngeal cancer patient whose cycle is seriously damaged. Accordingly, it is necessary to develop a new method that enables an analysis of high reliability for the voice signals that cannot be analyzed by the MDVP. To conduct the experiments of laryngeal cancer discrimination, the authors used three types of voices collected at the Department of Otorhinorlaryngology, Pusan National University Hospital. 50 normal males voice data, 50 voices of males with benign laryngeal diseases and 105 voices of males laryngeal cancer. In addition, the experiment also included 11 voices data of males with laryngeal cancer that cannot be analyzed by the MDVP, Only monosyllabic vowel /a/ was used as voice data. Since there were only 11 voices of laryngeal cancer patients that cannot be analyzed by the MDVP, those voices were used only for discrimination. This study examined the linear predictive cepstral coefficients (LPCC) and the met-frequency cepstral coefficients (MFCC) that are the two major cepstrum analysis methods in the area of acoustic recognition. Results : The results showed that this met frequency scaling process was effective in acoustic recognition but not useful for laryngeal cancer discrimination. Accordingly, the linear frequency cepstral coefficients (LFCC) that excluded the met frequency scaling from the MFCC was introduced. The LFCC showed more excellent discrimination activity rather than the MFCC in predictability of laryngeal cancer. Conclusion : In conclusion, the parameters applied in this study could discriminate accurately even the terminal laryngeal cancer whose periodicity is disturbed. Also it is thought that future studies on various classification algorithms and parameters representing pathophysiology of vocal cords will make it possible to discriminate benign laryngeal diseases as well, in addition to laryngeal cancer.

• Radiation Oncology Journal
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• v.23 no.1
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• pp.17-21
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• 2005

Purpose : To evaluate the voices of irradiated patients with early glottic carcinoma and to compare these with the voices of healthy volunteers. Materials and Methods : The voice samples (sustained vowel) of seventeen male patients who had been irradiated for T1a glottic squamous carcinoma at least 1 year prior to the study were analyzed with objective voice analyzer (acoustic voice analysis, aerodynamic test, and videostroboscopic analysis) and compared with those of a normal group of twenty age- and sex-matched volunteers. Average fundamental frequency, jitter, shimmer, and noise-to-harmonic ratio were obtained for acoustic voice analysis. Maximal phonation time, mean flow rate, intensity, subglottic pressure, glottal resistance, glottal efficiency, and glottal power were obtained for aerodynamic test. Results : The irradiated group presented higher values of shimmer in acoustic voice analysis. There was no significant difference between two groups in other parameters. Conclusion : In this study all the objective voice parameters except shimmer were no4 significantly different between the irradiated group and the control group. These results suggest that the voice quality is minimally affected by radiation therapy for 71 a glottic carcinoma.