• 대한후두음성언어의학회지
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• 제14권1호
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• pp.51-53
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• 2003

Amyotrophic lateral sclerosis Is an unusual pattern of distal muscular atrophy with permanent bulbar sign. Vocal fold paralysis and velopharyngeal insufficiency(VPI) due to soft palate paralysis Is occasionally associated with distal muscular atrophy. Recently we experienced a case of amyotrophic lateral sclerosis whose symptom was initially expressed with hoarseness and VPI. So we report a case with review of literature.

• 대한후두음성언어의학회지
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• 제29권2호
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• pp.70-75
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• 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
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• 제16권2호
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• pp.129-134
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• 2005

Background and Objectives : Artecoll(R) is an injectable soft tissue filler, which is a suspension of polymethylmethacrylate microspheres in $3.5\%$ bovine collagen solution. The authors aimed to determine the clinical of Artecoll of Artecoll(R) as an injection material into the vocal fold to correct the glottal insufficiency caused by unilateral vocal cord paralysis. Materials and Methods : Forty-one consecutive patients with unilateral vocal cord paralysis received percutaneous Artecoll injections under local anesthesia. Acoustic, aerodynamic and stroboscopic analyses were prospectively provided before, 1 week and 3 months after injection. Perceptual GRBAS grading by speech language pathologists and subjective ratings of the hoarseness and aspiration by the patients were also obtained. Results : Aerodynamic parameter(maximal phonation time) were significantly improved after the injection (p<0.05). Acoustic parameters (jitter and shimmer) were improved at the 3rd month follow-up. GRBAS uading and patients own subjective scaling of hoarseness and aspiration also showed significant improvement (p<0.05). Early or delayed significant side effects were not observed. Conclusion : Vocal fold injection with Artecoll is a convenient, safe and useful method of temporarily correcting the glottal insufficiency. Further long-term follow-up studies will answer the usefulness and safety of the Artecoll injection laryngoplasty.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.11-15
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• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

• 대한후두음성언어의학회지
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• 제9권2호
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• pp.128-133
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• 1998

Background and Objectives : Despite of numerous treatment modalities for glottic insufficiency, it still remains unresolved problem. Recently, autologous collagen injection was introduced as a new treatment for glottic insufficiency. This study was attempted to evaluate the efficacy of this treatment modality. Materials and Methods : Ten patients diagnosed as symptomatic sulcus vocalis with glottic insufficiency and agreed with this procedure were selected. Injectable collagen was obtained from the patient's dermis. It was injected into the pathologic area of the vocal fold. After injection, 4 of 10 patients were 1311owe4 up more than 5 months, and their voice were evaluated prior to injection and at 5 months after injection, using subjective, perceptual, aerodynamic, acoustic and videostroboscopic assessments. Results : In the aerodynamic assessment, 2 of 4(50%) patients was improved in MFR(mean flow rate), but no change was noted in MPT(maximum phonation time). In the acoustic assessment, no definite improvement was noted. In the subjective and perceptual assessments, 2 of 4(50%) patients was improved. In the videostroboscopic assessment, chink was reduced but still remained. Serious complication was not noted. Conclusion : Autologous collagen injection was reported as ideal treatment for glottic insufficiency, but our results were relatively unsatisfactory. But considering that our study is preliminary, it is too hasty to determine the efficacy of autologous collagen injection. We think that further study is required.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.118-122
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• 2017

Background and Objectives : In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. Materials and Methods : This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. Results : Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), ${\Delta}$ jitter (p<0.001), ${\Delta}$ shimmer (p=0.031), and ${\Delta}$ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. Conclusion : Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.127-132
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• 2006

Background and Objectives : Functional dysphonia is a voice disturbance in the absence of structural or neurologic laryngeal pathology characterized by voluntary misuse of laryngeal muscles. The present report reviews clinical characteristics of 25 patients with functional dysphonia. Materials and Method : We analyzed medical records, perceptual and acoustic analysis of voice samples, aerodynamic studies and laryngoscopy. Results : There was no sex or age predilection. Eighty four percent of patients presented sudden onset of symptoms and 76% had specific events at the onset. Most patients showed breathy or strained voice and various degree of vocal fold insufficiency with supraglottic compensatory contractions. Acoustic analysis revealed non-diagnostic, but mean flow rate was lower than normal in all cases. All patients responded to voice therapy except for 4 patients who were tort to follow up. Mean number of voice therapy sessions required to get responses is 1.9 sessions. Conclusion : We concluded that patients with functional dysphonia responded very well to short-term voice therapy and should be included in differential diagnosis in patients with dysphonia cannot be explained by structural or neurologic etiology.