• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.94-96
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• 2015

Several distinct pathologic entities are encompassed in benign vocal fold lesions, including intracordal cysts, vascular ectasia, as well as vocal fold nodules and vocal fold polyps. Treatment options for theses lesions include both medical/conservative and surgical techniques. First approaches should be focus on correcting the underlying causative factors, largely through voice therapy and education. There are several laryngomicrosurgery techniques for removal of benign lesions. Much debate continues regarding the relative merits of cold instruments versus carbon dioxide laser removal of benign vocal fold lesions. Both techniques have the merits and the demerits each other. Therefore the surgeon should well comprehend the merits of each techniques and choose the proper procedure for patient's lesions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.2
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• pp.131-135
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• 2009

Background and Objectives: Benign vocal fold lesions have shown various voice onset types on phonation, however, they have not been documented yet. We studied to know the relationships between benign vocal fold lesions and voice onset types. Materials and Method: 114 subjects were evaluated by using videokymographic examinations. The subjects were classified into three types: normal, contact, and open types according to the patterns of voice onset types on phonation. Benign vocal fold lesions were investigated and voice onset types were compared between normal and disease groups. Voice parameters were obtained from and compared in all subjects to assess acoustic and aerodynamic factors. Results: The normal type among onset types were more than contact type or open type in both normal and disease groups. Disease group showed many contact and open types when. compared with normal group. Vocal nodule and vocal polyp were showed many normal and contact types, however, sulcus vocalis was almost showed open type among voice onset groups. The values of mean flow rate (MFR) of contact type were significantly higher compared to normal type in disease group (p<0.05). Shimmer of contact type was higher than normal type in diseasegroup, but the difference was not significant (p=0.057). Conclusion: Benign vocal fold lesions were related to the various types of voice onset. The various types of voice onset should be considered when benign vocal fold lesions were examined.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.97-100
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• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.5-17
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• 2002

Objectives : Videostrobokymography(VSK) has been recently developed and reported by Sung et at. We aimed to analyze vibratory patterns and objective parameters in various benign vocal fold lesions using VSK, and examine the efficacy of VSK in clinical application. Materials and Methods : Using VSK, we analyzed the vibration pattern of normal vocal fold and various benign lesions, such as nodules, polyps, cysts, Reinke's edema and unilateral vocal fold paralysis. We also calculated objective parameters, open quotient and asymmetric index, and compared them with mean values of parameters in normal controls. Results : In nodules, polyps, and cysts, the open quotient on the site of the lesion was similar to the mean value in normal controls, however, on the other part of the vocal folds it was much larger than normal mean value. In Reinke's edema, irregular and asymmetric vibration was observed. The posterior portion of the vocal folds showed larger open quotients than the anterior portion. In the unilateral vocal fold paralysis, irregular vocal folds vibration and incomplete closure of the vocal folds were documented. Much larger asymmetric indices were calculated in the unilateral vocal fold paralysis than in normal controls and other lesions. The asymmetric index could be a good quantitative parameter of vibration from a patient with vocal fold paralysis. Conclusion : This study demonstrated that VSK could generate clear quantitative documentations of fine vibrations of vocal folds in many different benign lesions. VSK has a potential as an effective tool for quantitative analysis of vibratory patterns of the vocal folds iii clinical settings.

• Speech Sciences
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• v.7 no.1
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• pp.89-96
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• 2000

Examination of the vibrations of the vocal fold is very important in patients with voice changes. The newly developed videokymography (VKG) takes images in real time and records irregular vibrations of the vocal fold. However, there are few data on VKG findings. We studied VKG to evaluate the vibratory characteristics of the vocal fold in benign vocal fold lesions. Unique vibratory patterns, blurred demarcation of the mucosal propagation, decreased margin amplitudes, asymmetry in phase or amplitude, and a level difference of the contact site were observed in each benign vocal-fold lesion. We conclude that each type of laryngeal lesion has specific characteristic which are revealed by VKG examination, these parameters can be quantified and used to objectively evaluate VKG findings. Based on these results, VKG can be used as a supplementary diagnostic tool.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.101-103
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• 2015

There are no standard consensus about treatment results and prognostic factors based on randomized trials for benign vocal fold lesion. Currently, voice therapy is the treatment of choice for vocal nodules, and laryngomicroscopic surgery is for vocal polyps. There are no strong evidences to support it, based on randomized controlled trials, But, it's just a consensus among laryngologist. Considering the pathophysiology of benign vocal cord lesions, cognitive behavioral therapy that corrects the patient's bad voice habits and improves their vocal hygiene could be most important factor for treatment outcomes.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.37-40
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• 2018

Background and Objectives : This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. Materials and Methods : The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. Results : Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p<0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p<0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). Conclusion : Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

• Phonetics and Speech Sciences
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• v.10 no.4
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• pp.155-161
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• 2018

The purpose of this study was to evaluate the efficacy of a multiple voice therapy technique ($SKMVTT^{(R)}$) using laughter for the treatment of various benign vocal fold lesions. To achieve this, 23 female patients diagnosed with vocal nodules, vocal polyp, and muscle tension dysphonia through videostroboscopy were enrolled in vocal hygiene and $SKMVTT^{(R)}$. All of the patients were treated once a week for 4 to 12 sessions. The GRBAS scale was used to confirm the changes in voice quality before and after the treatment. Acoustic analysis was performed to evaluate jitter, shimmer, NHR, fundamental frequency variation, amplitude variation, PFR, and dB range. Videostroboscopy was performed to confirm the changes in the laryngeal features before and after the treatment. After the $SKMVTT^{(R)}$, the results of the perceptual evaluation demonstrated that the G, R, and B scales significantly improved. An acoustic evaluation also demonstrated that jitter, shimmer, NHR, vAm, vFo, PFR, and dB range also significantly improved after the $SKMVTT^{(R)}$. In comparison to the videostroboscopic findings, the size of the vocal nodules and vocal polyp decreased or disappeared after the treatment. In addition, the size of the cuneiform tubercles decreased, the length of the aryepiglottic folds became longer, and the laryngeal findings of the supraglottic compressions improved after the $SKMVTT^{(R)}$. These results suggest that the $SKMVTT^{(R)}$ is effective in improving the vocal quality of patients with benign vocal fold lesions. In conclusion, it seems that laughter and inspiratory phonation suppressed abnormal laryngeal elevation and lowered laryngeal height, which seems to have the effect of improving hyperfunctional phonation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.17-21
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• 1998

Benign vocal fold lesions such as polyps, nodules and edema are known to be caused by vocal trauma such as voice misuse and/or abuse. Even though these lesions are known to be caused by the same etiology, phonotrauma, they show widely different clinical features and different responses to voice therapy. Previous studies suggested that benign vocal fold lesions represent disturbance in the balance of the extracellular matrix(ECM) constituents of the vocal folds. Collagen is one of the major constituents of ECM. Among collagens, fibrillar collagens are most important ones for maintaining the structural integrity. On the basis of gross morphology, vocal polyps wert divided into angiomatous one and edematous one, and nodules were divided into conical one and sessile one. In these four groups, the pattern of distribution of various fibrillar collagens(type 1, 2, 3, 5) was studied by immunohistochemical staining using paraffin embedded tissues. Within each group, differences among collagen subtypes were insignificant. In edematous polyp, collagens were sparsely dispersed in lamina propria by diffuse edema. In angiomatous polyp, collagens were displaced into submucosal layer by hemorrhagic space. In nodules, collagens were stained compactly in lamina propria. Quite different distributions of fibrillar collagens between polyps and nodules are thought to suggest that vocal polyps and nodules are totally different disorders in their pathophysiology.

• Speech Sciences
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• v.14 no.4
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• pp.179-200
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• 2007

In voice pathology, various measurements calculated from pitch values are proposed to show voice quality. However, those measurements frequently seem to be inaccurate and unreliable because they are based on some wrong pitch values determined from pathological voice data. In order to solve the problem, we compared several pitch estimation methods to propose a better one in pathological voices. From the database of 99 pathological voice and 30 normal voice data, errors derived from pitch estimation were analyzed and compared between pathological and normal voice data or among the vowels produced by patients with benign vocal fold lesions. Results showed that gross pitch errors were observed in the cases of pathological voice data. From the types of pathological voices classified by the degree of aperiodicity in the speech signals, we found that pitch errors were closely related to the number of aperiodic segments. Also, the autocorrelation approach was found to be the most robust pitch estimation in the pathological voice data. It is desirable to conduct further research on the more severely pathological voice data in order to reduce pitch estimation errors.