• Title/Summary/Keyword: Vocal fold palsy

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Type I Thyroplasty Using Hydroxylapatite Implant($VoCoM^{(R)}$) (Hydroxylapatite 보형물($VoCoM^{(R)}$)을 이용한 제1형 갑상연골성형술)

  • Park, Young-Hak;Song, Chang-Eun;Im, Dong-Jae;Cho, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.1
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    • pp.11-15
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    • 2007
  • Background and Objectives: $VoCoM^{(R)}$ is a set composed of prefabricated hydroxylapatite implants and shims of various sizes that are designed for the type I thyroplasty, Authors aimed to evaluate the efficacy of $VoCoM^{(R)}$ System in type I thyroplasty. Materials and Method: Twenty three patients with unilateral vocal cord palsy were included in the study, who received type I thyroplasty with $VoCoM^{(R)}$ between May 2000 and May 2007 in St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea, Acoustic, aerodynamic and stroboscopic analyses were performed pre-and post-operatively, Subjective voice improvement was analysed by Voice handicap index, Results : Preoperative jitter was $4.68{\pm}2.46%$ and improved to $3.19{\pm}1.94%$(P<0,05), Preoperative NHR was $0.26{\pm}0.1$ and improved to $0.18{\pm}0,07$(P<0.05), Preoperative MPT was $6.16{\pm}4.9$secs improved to $9.55{\pm}4.67$secs(p<0.05), The postoperative stroboscopy revealed an effective medialization of vocal fold of all patients, Conclusion: Type I thyroplasty using $VoCoM^{(R)}$ is a efficient, safe and convenient way of vocal fold medialization at the expense of its high cost and difficulty in removal.

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The Effect of Steroid Therapy for Idiopathic Unilateral Vocal Cord Palsy (특발성 일측성 성대마비에서 경구 스테로이드 요법의 효과)

  • Bae, Jong-Won;Lee, GilJoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.107-111
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    • 2019
  • Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient's dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.

Intraoperative Recurrent Laryngeal Nerve Monitoring in a Patient with Contralateral Vocal Fold Palsy

  • Na, Bub-Se;Choi, Jin-Ho;Park, In Kyu;Kim, Young Tae;Kang, Chang Hyun
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.391-394
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    • 2017
  • Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use.

IgG4 Related Disease Misdiagnosed to Carotid Body Tumor (경동맥소체종양으로 오인된 IgG4 연관 질환)

  • Lee, Gun Hyuk;Song, Ji-Sun;Yoon, So Yeon;Cho, Youn Jin;Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.27-31
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    • 2020
  • Neck mass has various etiologies, including inflammatory, congenital, neoplastic causes. The IgG4-related disease can cause symptoms in the head and neck areas with an inflammatory neck mass. It also shows clinical and pathological findings from inflammation caused by immune reactions, such as lymphocyte and plasma cell infiltration, storiform fibrosis, obliteration phlebitis, and invigorated serum IgG4 levels. The treatment guideline has not been established and still under debate, but systemic glucocorticoid seems to be effective in the most cases. In this brief report, a 48-year-old male patient presented with voice change for 3 weeks. Left side paramedian vocal fold palsy was observed in the flexible laryngoscopy. About 2.5×2.0×1.2cm size, heterogeneously enhanced neck mass with irregular margin encasing left carotid artery was noted on preoperative contrast enhanced neck CT scan, and it was suspicious of left carotid body tumor. The pathology shows IgG4-related disease rather than carotid body tumors. We report this case of IgG4-related disease, which can be misdiagnosed to carotid body tumors.

New Parameter on Speech and EGG; Glottal Closure Delay Ratio (음성신호와 전기성문파를 이용하는 새로운 매개변수 ; 성대 폐쇄 지연비율(Glottal Closure Delay Ratio))

  • Choi, Jong-Min;Kwon, Tack-Kyun;Jung, Eun-Jung;Lee, Myung-Chul;Kim, Kwang-Hyun;Sung, Myung-Whun;Park, Kwang-Suk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.1
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    • pp.22-25
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    • 2007
  • Background and Objectives: Biomedical signals have been usually used for the diagnosis of the laryngeal function such as speech, electroglottograph(EGG), airflow and other signals. But, in most cases these signals were analysed separately. Here, we propose a new interchannel parameter Glottal Closure Delay Ratio(GCDR) which is estimated from speech and EGG measured simultaneously. Materials and Method: Speech and EGG signal were recorded simultaneously from 13 normal subjects, 39 patients. The patients' data included 16 polyps and 23 vocal folds palsy. Time difference between glottal closing instance on EGG and the first maximum peak on speech in a pitch period was calculated. Glottal closing instance was defined as the maximum peak on the first derivative of EGG signal(dEGG). Results: The standard deviation and jitter were calculated using 20-30 GCDRs extracted from each data, and they are significant different between normal and vocal fold paralysis group. Conclusion: The GCDR may be the first index reflecting speech and EGG characteristics and the perturbation of this parameter was significant different between normal and vocal fold paralysis group.

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Vocal Fold Palsy Induced by Seldinger Technique for Totally Implantable Venous Access Device (셀딩거 방법을 이용한 TIVAD 삽입 시 발생한 성대마비 1예)

  • Park, Hoon;Lee, Myung-Chul;Kim, Young-Bum;Lee, Guk-Haeng
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.2
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    • pp.129-131
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    • 2012
  • 셀딩거 방법을 이용한 TIVAD 삽입 시 신경손상으로 인하여 성대마비가 발생할 가능성은 아주 낮은 것으로 알려져 있다. 본원에서 셀딩거 방법을 이용한 TIVAD 삽입 후 우측 성대마비가 발생한 18세 남아환자에서 초음파 검사를 시행하여 미주신경의 손상을 확인한 증례가 있어 보고하고자 한다.

Type I Thyroplasty Using Prefabricated Hydroxylapatite Implant(VoCoM$^{\circledR}$) (미리 제작된 Hydroxylapatite 보형물을(VoCoM$^{\circledR}$) 이용한 제 1 형 갑상성형술)

  • 이현종;정한신;백정환;손영익
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.2
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    • pp.117-122
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    • 2003
  • Background and Objectives : $VoCoM^{\circledR}$ is a commercialized set composed of prefabricated hydroxylapatite implants and shims of various sizes which are specially designed for the type I thyroplasty. Even though a previously published preliminary report showed that $VoCoM^{\circledR}$ is a convenient and safe product for the type I thyroplasty, further investigations or experiences are yet to be reported. Authors aimed to evaluate the efficacy of $VoCoM^{\circledR}$type I thyroplasty, and its advantage and/or disadvantage. Materials and Method : Twenty three consecutive patients with unilateral vocal cord palsy enrolled for the study, who received type I thyroplasty with $VoCoM^{\circledR}$ between July 2001 and June 2003. Acoustic, aerodynamic and stoboscopic analyses were performed prior to surgery and 1 to 3 months after surgery. Speech language pathologists evaluated their voice quality by GRBAS scale, and patients themselves reported subjective changes of their voice by visual analog scale. Results : The average time for the operation was 80 min, which is about 30 min less than other methods. Preoperative jitter was 3.25$\pm$1.65% and improved to 1.94$\pm$1.79% postoperatively (p<0.05). Preoperative shimmer was 9.72$\pm$6.56% and improved to 5.61 $\pm$3.76% (p<0.05), Maximal phonation time increased from 4.41$\pm$2.99 to 7.98$\pm$4.35 sec (p<0.05) The postoperative stroboscopy revealed an effective medialization in 91.3% of the patients. The subjective phonetic improvements were reported in 21 out of 23 patients. GRBAS scale improved from 2.71$\pm$0.46 to 1.47$\pm$1.12(p<0.05). Additional medialization with $Gore-Tex^{\circledR}$ was easily performed in two revision cases. Previously inserted $VoCoM^{\circledR}$ implant was hard to remove because of the tight integration of soft tissues around the implant. Side effects such as extrusion or foreign body reaction are not observed. $VoCoM^{\circledR}$ was relatively expensive and costed more than 10 times of $Gore-Tex^{\circledR}$. Conclusion : Prefabricated hydroxylapatitie implant($VoCoM^{\circledR}$) provides a convenient, safe and efficient way of vocal fold medialization. However it is relatively expensive and hard to remove.

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Single-Port Video-Assisted Thoracic Surgery for Secondary Spontaneous Pneumothorax: Preliminary Results

  • Kim, Min-Seok;Yang, Hee Chul;Bae, Mi-Kyung;Cho, Sukki;Kim, Kwhanmien;Jheon, Sanghoon
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.387-392
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    • 2015
  • Background: The aim of this study was to evaluate the feasibility of single-port video-assisted thoracic surgery (VATS) in the treatment of secondary spontaneous pneumothorax (SSP). Methods: Twenty-four patients who were scheduled to undergo single-port VATS for SSP were studied. The medical records of the patients were retrospectively reviewed. The mean follow-up duration was $26.1{\pm}19.8$ months. In order to evaluate the feasibility of single-port VATS for SSP, the postoperative results of single-port VATS (n=15) in patients with emphysema were compared with those of emphysematous patients who underwent three-port VATS (n=15) during the study period. Results: Single-port VATS was feasible in 19 of 24 patients (79.2%), while an additional port was needed in five patients. In the single-port VATS patients, the median operation time, duration of chest tube drainage, and hospital stay were 84.0 minutes, one day, and two days, respectively. Postoperative complications included prolonged chest tube drainage for more than five days (n=1), wound infection (n=1), and vocal fold palsy (n=1). No recurrence of pneumothorax was observed during the follow-up period. The median operation time, duration of chest tube drainage, and hospital stay of the emphysematous patients who underwent single-port VATS were shorter than those who underwent three-port VATS group (p<0.05 for all parameters). Conclusion: Single-port VATS proved to be a feasible procedure in the treatment of patients with secondary spontaneous pneumothorax.