• 대한후두음성언어의학회지
• /
• 제12권1호
• /
• pp.5-10
• /
• 2001

성대 내 주입에 의한 음성수술은 적절한 접근방법을 통해 적절한 주입물을 선택한다면 여러가지 음성장애에 대한 매우 우수한 치료중의 하나이다. 자가지방이 성대내주입술과 내시경적 성대내주입술은 최근에 개발된 수술방법이다. 성대 내 주입물질을 다룰 때 반드시 세심한 주의를 기울여야하고, 환자의 요구에 맞게 환자의 현 상태에 가장 적합한 주입물을 선택하도록 하여야 하며, 시술 시에는 주입하려고 하는 정확한 위치에 주입하여야 한다.

• 대한후두음성언어의학회지
• /
• 제15권2호
• /
• pp.87-91
• /
• 2004

Background and Objectives : Temporary vocal fold injection is not only performed to restore the laryngeal function in temporary unilateral vocal fold paralysis or paresis, but also performed as a test injection prior to the permanent injection. Gelfoam has been safely used for the past several decades for the temporary vocal fold augmentation. Recently, we found a new material, called Radieses Lite, may be used as a temporary injection material. Material and Methods : We report preliminary results of 11 patients who had Radiesse Lite injection with a variety of pathologies. Results : Based on the results from the 6 patients who completed follow-up, the duration of effectiveness of Radiesse Lite seems to be from 2 to 3 months depending on the injection amount. Radiesse Lite satisfies several requirements of the ideal temporary vocal fold injection material in terms of injectability, convenience, duration of effectiveness and safety. Conclusion : The authors concluded that Radiesse Lite might be a good option for temporary vocal fold injection especially in the office setting.

• 대한후두음성언어의학회지
• /
• 제29권2호
• /
• pp.70-75
• /
• 2018

The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.

• 대한후두음성언어의학회지
• /
• 제11권2호
• /
• pp.185-187
• /
• 2000

The etiology of vocal fold granuloma was identified : post-endotracheal intubation, vocal abuse, acid reflux and idiopathic. The identification of the cause or causal factor is important, since the treatment must be fundamental directed at them. Treatment have included voice therapy and antireflux measures. Surgical excision is considered in patients who do not respond to medical management. In this study, a case of vocal fold granuloma resolved who underwent injection of the affected vocal fold. Botulinum toxin type A is probably successful by decreasing the strength during adduction in the arytenoid region which, when very intense, would perpetuate the granuloma. Localized injection of this neurotoxin is promising both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy.

• 대한후두음성언어의학회지
• /
• 제26권2호
• /
• pp.97-100
• /
• 2015

Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.

• 대한후두음성언어의학회지
• /
• 제14권1호
• /
• pp.40-46
• /
• 2003

Background and Objectives : The vocal fold granuloma has been associated with vocal abuse, gastroesophageal reflux, endotracheal intubation and habitual throat clearing etc.. Granuloma is benign growth of hypertrophic granulation tissue. It is usually located on the posterior third of vocal fold, in one or both vocal process of the arytenoid cartilage In spite of the voice therapy, steroid therapy, anti-reflex therapy and surgical procedure. The distinct advantage and uniform success rate of each methods have not been generally shown. Authors report that localized injection of botulinum toxin type A (BOTOX$^{\circledR}$) is the promising method both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates. Materials and Method : We carried out a retrospective study of 9 patients with the diagnosis of vocal fold granuloma on the videostroboscopic examination from Jan 2000 to Mar 2003. The botulinum toxin type A was injected into one or both thyroarytenoid muscle or lateral cricoarytenoid muscle under the electromyography. The average dosage ranges from 6U to 8U per injection. Results : Unilateral vocal fold granuloma in 7 patients had been resolved completely within 2-3 months after first injection : 5 patients received th\ulcorner GER medical therapy in addition to the Botulinum toxin injections, 2 patients was resolved completely who had shown recurrence after $CO_2$ laser vaporization. 2 patients who had shown recurrence after $1^st$ injection were also completely resolved within 6 months after further injections. Conclusion : We expect that localized injection of Botulinum toxin type A can provide an alternative treatment for the refractory cases to the traditional forms of therapy and avoid the recurrence in conjunction with proper medical and voice therapy against GER and vocal abuse.

• 대한후두음성언어의학회지
• /
• 제33권1호
• /
• pp.1-6
• /
• 2022

Vocal fold injection (VFI) is widely accepted as a first line treatment in treating unilateral vocal fold paralysis and other vocal fold diseases. Although VFI is advantageous for its minimal invasiveness and efficiency, the invisibility of the needle tip remains an essential handicap in precise localization. Real-time light-guided vocal fold injection (RL-VFI) is a novel technique that was developed under the concept of performing simultaneous injection with precise placement of the needle tip under light guidance. RL-VFI has confirmed its possibility of technical implementation and the feasibility in injecting the needle from various directions through ex vivo animal studies. Further in vivo animal study has approved the safety and feasibility of the procedure when various transcutaneous approaches were applied. Currently, RL-VFI device is authorized for clinical use by the Ministry of Food and Drug Safety in South Korea and is clinically applied to patients with safe and favorable outcome. Several clinical studies are currently under process to approve the safety and the efficiency of RL-VFI. RL-VFI is expected to improve the complication rate and the functional outcome of voice. Furthermore, it will support laryngologists in overcoming the steep learning curve by its intuitive guidance.

• 대한후두음성언어의학회지
• /
• 제31권2호
• /
• pp.56-60
• /
• 2020

Vocal fold injections are usually performed with a patient wake in an office under local anesthesia. For comfortable and safe office-based procedures, thorough anesthesia and premedication should be provided to the following three regions; nasal cavity, oropharynx, and larynx. Topical lidocaine is most widely used anesthetics on office based procedure. Lidocaine has a low to intermediate potency, 45 minutes to 60 minutes' duration of action, and onset of sufficient anesthesia within 90 seconds of topical administration. Tetracaine, prilocaine, ropivacaine, and bupivacaine also have been used in the office-based procedures. Nasal decongestant, oxymetazoline, is also used for widening nasal cavity by constriction of nasal mucosa. The amount of topical and local anesthetics used in vocal fold injection rarely exceeds toxic doses. The physician should know proper anesthesia techniques and must be familiar with the safe dose and complication of all anesthetics used.

• 대한후두음성언어의학회지
• /
• 제21권1호
• /
• pp.32-36
• /
• 2010

Background : Vocal fold injection using autologous material (fat or collagen) is very useful. However, Autologous material have variable resorption times and results, Plasma gel is a new injection material. The purpose of this study is to introduce a new injection material and discuss the effectiveness and complications. Subjects and Method: Eleven cases with vocal cord paralysis were analyzed after plasma gel injection, The plasma gel was acquired from patient's own blood. The preoperative and postoperative parameters including maximum phonation time (MPT) and subject aspiration score were analyzed. Results: There was a significant improvement in MPT and aspiration score in the case of vocal cord palsy. There was only one laryngeal complication. Conclusion : According to these preliminary results, the injection laryngoplasty with Plasma gel is a simple, safe, cheap procedure for temporally vocal fold palsy.

• 대한후두음성언어의학회지
• /
• 제29권2호
• /
• pp.83-86
• /
• 2018

Background and Objectives : This study aimed to evaluate efficacy and complication of injection laryngoplasty using calcium hydroxyapatite (CaHA) for unilateral vocal fold paralysis in Asian. Materials and Methods : A prospective study was conducted on the adult patients with unilateral vocal fold paralysis from May 2015 through January 2016. Injection laryngoplasty was performed by one laryngologist. All patients underwent prospective voice evaluation using the subjective and objective comprehensive battery of assessments, before the procedure and after the procedure at 3 months, and 6 months. Results : A total of 7 patients (5 males and 2 females) were included in this study. VHI-10 was significantly decreased after injection laryngoplasty, at postoperative 6 months (p=0.031), while VAS score and MDADI showed no difference. GRBAS scale gradually decreased in 3 months and 6 months follow-up without statistical significance. Acoustic analysis revealed that jitter, shimmer, and noise-to-harmonic ratio continuously decreased from the baseline at 3 months and 6 months, although statistical significance was not attained. In the aerodynamic analysis, maximal phonation time was gradually increased at 3months and 6 months with significant difference (p=0.016, 0.031, respectively). There was no side effect associated with the procedure. Conclusion : CaHA can be safely used in Asian patients and the onset of maximal efficacy seems to be slow than other studies with Caucasian patients.