• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.24-28
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• 2021

Background and Objectives Vocal polyp is one of the most common benign diseases of vocal fold caused by overuse of voice. Laryngeal microsurgery is the first treatment of choice for vocal polyp. However, surgery has many risks such as side effects of general anesthesia, injury of tooth and psychological burden. And we often experience reduction of vocal polyps without surgical procedure. The purpose of study is to evaluate the effect of non-surgical treatment such as vocal hygiene education and proton pump inhibitor (PPI) in patients with vocal polyp. Materials and Method We performed retrospective study for seventy-three patients of vocal polyp who treated with non-surgical modalities such as vocal hygiene education and PPI over three months. Treatment outcomes and risk factors such as age, sex, polyp size, position, symptom duration, presence of laryngopharyngeal reflux (LPR) symptoms, smoking history, voice abuse history and vocal hygiene education were evaluated by comparison between polyp size improved group and non-improved group. Results 5.5% of enrolled patients showed complete response and 23.3% showed partial response without surgery. Polyp size improved group significantly carried out more practice of vocal hygiene education treatment than the non-improved group (p=0.040). And the presence of LPR symptoms [hazard ratio (HR) 3.368, confidence interval (CI) 1.055-10.754, p=0.040] and not performing of vocal hygiene education (HR 3.664, 95% CI 1.078-12.468, p=0.038). Conclusion Vocal hygiene education can be a useful treatment option when making a decision to treat with vocal polyp.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.1
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• pp.26-30
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• 2022

Background and Objectives Cough suppression therapy (CST) is a physiotherapy that can be used for patients with chronic refractory cough (CRC). We aimed to investigate the efficacy of CST for CRC. Materials and Method A prospective randomized controlled trial was conducted in 27 patients with CRC. Participants were randomized to receive either standard mucolytic medications for CRC combined with supplemental CST (CST group) or standard medications alone (control group). CST consists of laryngeal hygiene management, humidification, cough suppression technique, breathing method, and counseling. We assessed the symptoms change at baseline and week 4 with the Leicester Cough Questionnaire (LCQ). Secondary efficacy outcomes included the degree of cough Visual Analog Scale (VAS) score (0 to 100 scale). Results From 2019 to 2021, 14 CST group patients and 13 control group patients were included. The improvement was significantly greater in the CST group than in the control group for cough VAS score (36.67 to 13.33 vs. 74.29 to 16.43, p<0.001). Patients in the CST group had a significant improvement in total (70.14 to 107.71, p=0.005), physical (31.42 to 43.86, p=0.015), psychological (23.57 to 40.14, p=0.003), and social (15.14 to 23.71, p=0.005) LCQ scores. However, there was not a significant pre- to post-treatment LCQ score improvement in control group. Conclusion CST might be an effective supplemental intervention for CRC.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.1
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• pp.31-36
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• 2022

Background and Objectives Proton pump inhibitors (PPIs), mucolytics, and steroids were commonly recommended after phonomicrosurgery to prevent worsening of vocal fold (VF) scar formation and subglottal swelling. However, there is no consensus about whether laryngeal reflux and thick discharge are associated with the voice outcomes following phonomicrosurgery in benign VF lesions. The purpose of this study is to examine voice outcomes of use of PPIs, mucolytics,and steroids after phonomicrosurgery. Materials and Method This randomized controlled study is performed with patients undergoing laryngomicroscopic surgery for VF polyp and cyst. Participants were randomly assigned to 1) no medication, 2) PPIs, 3) PPIs+mucolytics, and 4) PPIs+mucolytics+steroids for 2 months postoperatively. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed pre- and post-operatively at 2 months. Parameters were compared among four groups. Results Among 85 patients, a total of 50 patients were included. The VHI-10, perceptual and acoustic parameters improved in all groups after surgery. However, there was no significant difference in those parameters among all groups. Conclusion PPIs, mucolytics, and steroids did not significantly influence voice outcomes after phonomicrosurgery in patients with benign VF lesions.

• Phonetics and Speech Sciences
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• v.14 no.3
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• pp.1-9
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• 2022

The current study examined English-speaking adult learners' production and perception of L2 Korean stops (/t/ or /t'/ or /t^h/) to investigate whether the two modalities are linked in utilizing voice onset time (VOT) and fundamental frequency (F0) for the L2 sound distinction and how the learners' L2 proficiency mediates the relationship. Twenty-two English-speaking learners of Korean living in Seoul participated in the word-reading task of producing stop-initial words and the identification task of labelling CV stimuli synthesized to vary VOT and F0. Using logistic mixed-effects regression models, we quantified group- and individual-level weights of the VOT and F0 cues in differentiating the tense-lax, lax-aspirated, and tense-aspirated stops in Korean. The results showed that the learners as a group relied on VOT more than F0 both in production and perception (except the tense-lax pair), reflecting the dominant role of VOT in their L1 stop distinction. Individual-level analyses further revealed that the learners' L2 proficiency was related to their use of F0 in L2 production and their use of VOT in L2 perception. With this effect of L2 proficiency controlled in the partial correlation tests, we found a significant correlation between production and perception in using VOT and F0 for the lax-aspirated stop contrast. However, the same correlation was absent for the other stop pairs. We discuss a contrast-specific role of acoustic cues to address the non-uniform patterns of the production-perception link in the L2 sound learning context.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.7-16
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• 2021

Purpose: The I-gel device is Korea's most frequently used airway management method during pre-hospital cardiopulmonary resuscitation (CPR). This study aimed to compare changes in ventilation volume according to the fixation method with a simulated manikin. Methods: We placed I-gel into an advanced life support simulator and compared tape and band fixation conditions. CPR was performed according to the 2020 Korean CPR guidelines, using a mechanical chest compression device and an adult bag. The positional shift of I-gel and the ventilation volume of the simulated manikin were measured after performing CPR for 20 minutes. Five trials were carried out in each setting. Statistical analysis was carried out with SPSS 27.0. P < .05 was considered significant. Results: Positional shift after 20 minutes of CPR was as follows: tape fixation, 7.2 ± 0.2 mm; band fixation, no change, indicating a significant difference between the two groups (p=.003). The mean ventilation volume was tape fixation, 482.63 ± 30.84 mL; band fixation, 544.96 ± 22.98 mL, showing a significant difference (p=.002). Conclusion: When using the I-gel during pre-hospital CPR, using a band-type fixing device with elasticity rather than fixing the tape provides stable and appropriate ventilation by maintaining the fixed position.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.2
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• pp.110-114
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• 2022

IgG4-related disease is a fibroinflammatory condition by infiltration of IgG4-positive plasma cells that often presents as a tumorous lesion. This disease can affect nearly every organ system. After the pancreas, the head and neck region is second most common site for presentation of IgG4-related disease such as Mikulicz's disease, Küttner tumor. The involvement of IgG4-related disease in laryngeal lesions is extremely rare. We have experienced a case of IgG4-related disease with pseudotumor formation in the larynx that is suggestive of malignancy in radiologic findings. But the pathology findings was finally confirmed as IgG4-related disease. Oral treatment with prednisolone was initiated, and the edematous mass reduced in size without permanent functional impairment of vocal fold mobility. We report our experience with a literature review.

• The Journal of Internal Korean Medicine
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• v.44 no.2
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• pp.158-166
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• 2023

Background: Adductor spasmodic dysphonia (ASD) is caused by the involuntary contraction of laryngeal muscles due to dystonia localized to the larynx. In the case of ASD, conventional treatment is mainly performed with a botulinum toxin injection. However, the botulinum toxin injection has a short-lasting effect and requires repeated injections. Alternatives are needed due to concerns over adverse effects, such as general weakness and airway aspiration caused by the botulinum toxin injection. Case report: A 46-year-old female patient with ASD complained of voice tremor and hoarseness. The combined Korean medical treatments-Ukgan-san-gami, Jakyakgamcho-tang, acupuncture, and transcutaneous electrical nerve stimulation (TENS)-were administered on the first day the patient was hospitalized. The Voice Handicap Index (VHI) was evaluated during the treatment. The VHI taken on the second day totaled 92 points. On the ninth day, 81 points were recorded. Total score gradually improved, and on the 16th day, 62 points were recorded. Combined Korean medical treatment lasted 19 days. Conclusion: The present case report suggests that a combined Korean medical treatment approach with Ukgan-san-gami, Jakyakgamcho-tang, acupuncture, and TENS might be effective for symptoms such as voice tremors and hoarseness. Combined Korean medical treatment can be a therapeutic option for patients with ASD.

• Journal of Veterinary Clinics
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• v.39 no.1
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• pp.1-8
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• 2022

The current, retrospective study aimed to assess the short-term prognosis and postoperative complications associated with the surgical correction of elongated soft palate using harmonic scalpel and to compare the postoperative complications associated with the application of harmonic scalpel and traditional surgery using Metzenbaum scissors. Harmonic scalpel was used to perform staphylectomy in 21 dogs. A total of ten dogs underwent sacculectomy; six dogs with harmonic scalpel and four dogs using Metzenbaum scissors. Stenotic nares were corrected by wedge resection. Postoperative complications were recorded through monitoring and radiographic examinations. Telephone interviews were conducted on the first, third, and seventh day after discharge and continued until the resolution of postoperative complications. Postoperative edema at the surgical site was identified and mitigated within a day or two. Snoring and dyspnea improved dramatically in the group that underwent staphylectomy alone. Moreover, three dogs presented with postoperative gastrointestinal complications, especially retching. The symptoms persisted for seven days and ten days in two dogs that underwent sacculectomy with harmonic scalpel and for two days in one dog that underwent sacculectomy with Metzenbaum scissors. The clinical signs and symptoms of brachycephalic syndrome disappeared without recurrence. Harmonic scalpel provides a hemostatic effect during staphylectomy, is convenient, and does not cause postoperative complications. Conversely, the use of harmonic scalpel during sacculectomy necessitated a longer period for the resolution of complications without any significant hemostatic efficacy, compared to traditional surgery.

• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.979-984
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• 2020

Cri-du-chat syndrome is a rare genetic disorder in which the patient presents with a characteristic high-pitched monotonous cry and recurrent aspiration pneumonia, attributed to abnormalities in the larynx, epiglottis, and nervous system. The most prominent brain MRI findings are the presence of pontine and cerebellar hypoplasia, which primarily involve posterior cranial fossa structures. Although atrophy of supratentorial structures were also a common radiological finding, it was considered to be a secondary change due to pontine hypoplasia. Here, we present the case of a three-month-old patient presenting with cri-du-chat at our institution. The patient also showed the presence of prominent pontine hypoplasia similar to previously reported cases; however, contrary to other cases, there was a general delayed myelination of brain instead of decreased myelination of anterior limb of internal capsule. Since the larynx, pons, and cerebellum all originated from similar notochord level, which suggests anomaly in early stage of development, laryngeal, and brain anomaly characteristically observed in the cridu-chat syndrome.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.596-603
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• 2021

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion: US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.