• 대한후두음성언어의학회지
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• 제19권2호
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• pp.117-122
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• 2008

Background and Objectives: $Radiesse^{(R)}$ is a gell-formed material of calcium hydroxylapatite (CaHA) and carboxymethylcellulose (CMC) used for vocal fold injections. The authors aimed to study injection laryngoplasty with $Radiesse^{(R)}$, and determine the efficacy of $Radiesse^{(R)}$ for unilateral vocal cord palsy using objective and subjective measures. Materials and Method: Nine patients with unilateral vocal cord palsy received injection laryngoplasty with $Radiesse^{(R)}$ under general anesthesia from Jul. 2007 to Jan. 2008. $Radiesse^{(R)}$ was injected with 25gauze long needle perorally or percutaneously. The Acoustic, aerodynamic, stroboscopic analysis and pre-injection/post-injection perceptual assessment were evaluated in all patients. Results: Postoperative jitter and shimmer scores tended to diminish compared to preoperative scores, and maximum phonation time increased with statistical significantly. Stroboscopic findings demonstrated improvement postoperatively. The degree of hoarseness, which is a part of perceptual assessment, decreased after the procedure. Conclusion: $Radiesse^{(R)}$ may be an altemative material for injection laryngoplasty. We suggest long-term follow up with more cases.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 2003년도 제19회 학술대회
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• pp.182-182
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• 2003

Objectives : The methods to treat glottic incompetence include thyroplasty type I, arytenoid abduction, and intracordal injection using various materials. The intracordal injection is easy and simple and does not require skin incision. In general, the grafted cartilage shows a high survival rate, a low absorption rate and small voluminous change. The authors performed injection of minced autologous auricular cartilage and fat using a Bruning injector in unilateral vocal cord palsy We evaluate the effect and safety of autologous auricular cartilage intracordal injection. Study Design : Retrospective study. Methods : Auricular cartilage was obtained by incising tragus vertically and it was minced with a scalpel and #15 blade. About 2g of abdominal fat was obtained by small periumbrical incision and cut into small pieces. The minced cartilage was put into a 1$m\ell$ injector and then the injector was filled with fat. The operation was conducted under laryngeal microscope. Minced cartilage was injected into the vocalis muscle at the junction of the middle and posterior third of the vocal fold. In three cases, we performed autologous cartilage intracordal injection. Results : We observed no postoperative complications, such as dyspnea, granulation, inflammation, in any of the cases. The voice was improved compared with the voice prior to operation in all cases. Conclusion : Although the cases are still limited and the observation period is short, we suggest that the autologous cartilage using the auricular cartilage is the ideal and new effective augmentative material in vocal cord palsy.

• 대한후두음성언어의학회지
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• 제6권1호
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• pp.39-42
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• 1995

Surgical treatment options of symptomatic unilateral vocal fold paralysis are Teflon injection, type Ⅰ thyroplasty, and arytenoid adduction. Arytenoid adduction is preferable to type Ⅰ thyroplasty for correcting the level different that may be present between two vocal folds and the large glottal chink However there is no known therapeutic modality effective to correct the large posterior glottal chink of the vocal fold with relatively normal mobility. Recently we have experienced a case of severe large posterior glottal chink of the vocal 1314s with relatively normal mobility after thyroid lobectomy, successfully treated with type Ⅰ thyroplasty combined with arytenoid adduction.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.138-142
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• 2006

Objectives : Vocal cord paralysis(VCP) is a complex disorder which may result from numerous causes. We reviewed and analyzed the trend of clinical characteristics and causes of VCP in Korean patient. Method : A total 197 patients with VCP who visited St.Mary's hospital from March, 2000 to August, 2006 were reviewed retrospectively. They were analyzed according to sex, age, cause of VCP, position of paralyzed vocal fold, treatment methods. Results : The male and female ratio was 1.6 : 1. The unilateral paralyzed vocal fold was fixed at paramedian position in 84% of the cases. The left vocal fold was paralyzed about 2 1/2 times as much as the right vocal fold. Among the causes of VCP 30.9% of the cases were due to postoperative paralysis, and most of those were developed after lung, mediastinal surgery. laryngeal EMG was performed in 47 patients for determines the prognosis and treatment method. In the unilateral VCP, 90 patients were treated with injection laryngoplasty, 21 patients were performed thyroplasty type I. Conclusion : The causes of VCP include various diseases, so, detection of the primary disease is very important, because many fatal diseases are included among the primary diseases, and late detection can cause serious problems. VCP is not only a disease entity in itself, but can be seen as a sign of an underlying disease.

• 대한후두음성언어의학회지
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• 제21권2호
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• pp.121-127
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• 2010

Background and Objectives : Unilateral vocal fold paralysis is generally treated using injection laryngoplasty or voice therapy. However, the decision of treatment method is dependent on clinician's preference and hospital facilities without specific criteria. The purpose of the study was to examine factors predictive of voice therapy outcome in patients with unilateral vocal fold paralysis. Materials and Method : 38 patients diagnosed as unilateral vocal fold paralysis, aged from 24 to 81 years and undergone voice therapy more than 1 month were included. After 3 to 12 (mean 5.1) sessions of voice therapy, subjects had divided into responder group (RG, 28 patients) and non-responder group (NRG, 10 patients) according to G scale change. Paramters of perceptual assessment, acoustic and aerodynamic measure, and videostroboscopy were compared between two groups, and factors predictive of voice therapy result were analyzed. Results : RG patients showed significantly reduced rough, breathy, asthenic voice after voice therapy. Change of MPT and MFR was more substantial in RG than in NRG. By videostroboscopy, RG patients showed significantly more mucosal wave symmetry, glottal closure, reduced glottal gap index during the closed phase of phonation, while NRG patients showed more occurrences of abnomal supraglottic activities during phonation (p < 0.05). Poor outcome of voice therapy significantly associated with increased asthenic scale, short MPT, and less glottal closure (p=0.02). In addition, 90% of patients with MPT more than 5 seconds were in RG, whereas 56% of patients with MPT less than 5 secondes were in RG. Conclusion : Voice therapy is useful for large proportion of patients with unilateral vocal fold paralysis as an initial treatment method. However, patients with large asthenia scale, large glottic gap or MPT less than 5 seconds tend to have poor voice therapy outcome, and early injection laryngoplasty maybe recommended for these patients.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.82-86
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• 2019

In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.

• 대한후두음성언어의학회지
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• 제22권1호
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• pp.18-22
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• 2011

Laryngeal framework surgery comprises medialization laryngoplasty and arytenoid adduction. Since their introduction in the 1970s, these procedures have become standard treatments for vocal fold paralysis and glottal incompetence. However, frequency of laryngeal framework surgery is conjectured to relatively decrease along with the introduction of injection laryngoplasty. In this manuscript, indications for laryngeal framework surgery were highlighted in contrast to those of injection laryngoplasty. The authors introduced the basic concepts and principles as well as surgical techniques of laryngeal framework surgery. Even though the incidence of major and/or minor complications after laryngeal framework surgery is not high, surgeons should be well aware of its possible complications and they should be familiar with tips and know-how to avoid or cope with complications.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어학회 2015년도 제42차 춘계학술대회
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• pp.17-17
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• 2015

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어학회 2017년도 제46차 춘계학술대회
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• pp.4-5
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• 2017

• 대한후두음성언어의학회지
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• 제9권2호
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• pp.152-155
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• 1998

Laryngeal framework surgery to improve change the voice is a challenging development in phoniatric surgery. Basically two categories can be distinguished : (1) attempted medialization of the vocal fold, as for the treatment of paralytic dysphonias (2) adjustment of the vocal fold's tension of transsexuals or mutational dysphonia. Vocal pitch can be elevated by various surgical technique 1) cricothyroid approximation 2) A-P expansion of the thyroid ala 3) longitudinal incision in the cords 4) intrachondral injection of the steroid, and 5) evaporation of the cords by $CO_2$ laser. We have experienced a case of pitch elevation procedure after transsexual operation. After transsexual operation, he had received anterior commissure laryngoplasty modified from Le Jeune with no change in voice pitch(Fo=110Hz). 8 monthes later, he had received cricothyroid approximation resulting in pitch elevation(Fo=160Hz).