1.A Case of Pyogenic Granuloma in Larynx
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2019;30(1):69-71
Pyogenic granuloma is one of the benign vascular neoplasm. The nomenclature is misnomer because pyogenic granuloma is not related to infection and granuloma. It represent histopathologically lobular capillary hemangioma. It is most commonly occurred on skin followed by oral cavity such as gingiva, lip, tongue and buccal mucosa. Herein, we report a extremely rare case of pyogenic granuloma which was developed on larynx of a 81 year-old male with review of literature.
Gingiva
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Granuloma
;
Granuloma, Pyogenic
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Humans
;
Larynx
;
Lip
;
Male
;
Mouth
;
Mouth Mucosa
;
Skin
;
Tongue
;
Vascular Neoplasms
2.Local Triamcinolone Injection and Oral Steroid in the Patients with Thyrohyoid Syndrome
Korean Journal of Otolaryngology - Head and Neck Surgery 2022;65(1):37-40
Background and Objectives:
Thyrohyoid syndrome is rare disease characterized by unilateral chronic neck pain on hyoid bone area. Currently, local triamcinolone injection was widely used, but oral steroid treatment was rarely tried. We compared the oral steroid and triamcinolone injection for the thyrohyoid syndrome. Subjects and Method Patients who had unilateral pain and tenderness at thyrohyoid membrane were enrolled while excluding those with other diseases, such as gastroesophageal reflux, by physical exam and history taking. Patients were treated with oral steroid (n=15) and local triamcinolone injection (n=11); pain scores based on the pretreatment and post-treatment numeric rating scale (NRS)-11 were compared between the groups.
Results:
Patients with thyrohyoid syndrome were comorbid with globus (42.3%), sore throat (19.2%), and radiating pain (15.4%). In the oral steroid group, posttreatment pain scores (4.0± 2.2) significantly improved (p=0.001) more than pretreatment pain scores (7.7±1.2). In the triamcinolone injection group, posttreatment pain scores (2.3±1.7) also significantly improved (p=0.003) more than pretreatment scores (7.5±1.4). None of the patients revealed treatment related complications. Pretreatment scores were not significantly different, but post-treatment scores wre significantly better in the triamcinolone injection group than in the oral steroid group (p=0.047).
Conclusion
Oral steroid treatment could be easily performed and have significant effects for patients with thyrohyoid syndrome. Local triamcinolone injection was more effective than oral steroid treatment.
3.Prediction of Unilateral Vocal Cord Paralysis Patients Through Machine Learning Analysis of Acoustic Parameters: A Preliminary Study
Seungtae KANG ; Su Na PARK ; Ji-Wan HA ; Ki-Su PARK ; Jiho LEE ; Janghyeok YOON ; Gil-Jin JANG ; GilJoon LEE
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2024;35(1):24-29
Background and Objectives:
The purpose of this study is to evaluate value of diagnostic tool for vocal cord palsy utilizing artificial intelligence without laryngoscopeMaterials and Method A dataset consisting of recordings from patients with unilateral vocal cord paralysis (n=54) as well as normal individuals (n=163). The dataset included prolonged pronunciations of the vowels /ah/, /u/, /i/, and vocal cord data from paralyzed patients. Various acoustic parameters such as Mel-frequency cepstral coefficients, jitter, shimmer, harmonics-to-noise ratio, and fundamental frequency statistics were analyzed. The classification of vocal cord paralysis encompassed paralysis status, paralysis degree, and paralysis location. The deep learning model employed the leave-one-out method, and the feature set with the highest performance was selected using the following methods.
Results:
Vocal Cord Paralysis Classifier: The classifier accurately distinguished normal voice from vocal cord paralysis, achieving an accuracy and F1 score of 1.0. Paralysis Location Classifier: The classifier accurately differentiated between median and paramedian vocal cord paralysis, achieving an accuracy and micro F1 score of 1.0. Breathiness Degree Classifier: The classifier achieved an accuracy of 0.795 and a mean absolute error of 0.2857 in distinguishing different degrees of breathiness.
Conclusion
Although the small sample size raises concerns of potential overfitting, this preliminary study highlights distinctive acoustic features in cases of unilateral vocal fold paralysis compared to those of normal individuals. These findings suggest the feasibility of determining the presence, degree, and location of paralysis through the utilization of acoustic parameters. Further research is warranted to validate and expand upon these results.
4.The Prognostic Role of the Surgical Approach and Adjuvant Therapy in Operable Mucosal Melanoma of the Head and Neck.
GilJoon LEE ; Chung Hwan BAEK ; Na Yeon CHOI ; Man Ki CHUNG
Clinical and Experimental Otorhinolaryngology 2017;10(1):97-103
OBJECTIVES: The aim of this study was to investigate the prognostic impact of the surgical approach and adjuvant treatment in operable malignant melanoma of head and neck (MMHN). METHODS: Retrospective reviews of 31 patients who underwent surgery-based treatment with curative intent, either by the endoscopic or external approach, for MMHN were performed to analyze recurrence patterns, salvage modalities, and oncological outcomes (disease-specific survival and disease-free survival). RESULTS: Overall recurrence rate was 61% (19/31). In stage III patients (n=24), 50% (12/24) developed recurrences with a median recurrence-free period of 6.0 months, and 30% (4/12) of them was successfully salvaged by reoperation with adjuvant radiotherapy. On the contrary, all stage IVA patients (n=7) developed recurrences with a median recurrence-free period of 4.4 months. Distant metastasis was the most common pattern of failure and no patients were salvaged. Among variables, age and T classification, not the surgical approach, were significant prognosticators for disease-free survival and disease-specific survival. Adjuvant radiotherapy was associated with a lower rate of local failure, compared to surgery alone (hazard ratio, 0.02; 95% confidence interval, 0.06 to 0.75; P=0.02). However, adjuvant systemic therapy was not effective in reducing the risk of failures for any pattern. CONCLUSION: Our data suggested that meticulous surgical resection, either by the endoscopic or external approach, with adjuvant radiotherapy increases the local control rate in MMHN.
Classification
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Disease-Free Survival
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Head*
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Humans
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Melanoma*
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Neck*
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Neoplasm Metastasis
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Prognosis
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Radiotherapy
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Radiotherapy, Adjuvant
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Recurrence
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Reoperation
;
Retrospective Studies
5.A Case of Sarcomatoid Carcinoma of the Larynx Mimicking Vocal Polyp.
Taehoon KIM ; GilJoon LEE ; Jin Ho SOHN
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2017;28(2):128-130
Sarcomatoid carcinomas are biphasic tumors which have surface epithelial changes and an underlying spindle-shaped neoplastic proliferation. A 62-year-old male with hoarseness came to our hospital for evaluation. A single smooth polypoid lesion was detected on his right true vocal fold by larnygoscope. The patient was diagnosed with vocal polyp and treated with surgical excision. Pathology report of the excised specimen was compatible with sarcomatoid carcinoma. Therefore, further surgical resection was performed to secure safety margins. We report a case of a sarcomatoid carcinoma patient who was clinically diagnosed as vocal polyp.
Hoarseness
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Humans
;
Larynx*
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Male
;
Middle Aged
;
Pathology
;
Polyps*
;
Vocal Cords
6.Effect of Oral Water Intake to Globus Pharyngeus with Non-Organic Diseases.
Hak Geon KIM ; A Young KIM ; Eunjoo CHA ; GilJoon LEE
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2017;28(1):38-42
BACKGROUND AND OBJECTIVES: Globus pharyngeus is a sensation of foreign body in the throat. There are many studies evaluate relationships between globus pharyngeus and organic diseases such as laryngopharyngeal reflux, esophageal motility disorders as well as psychotic causes. But, Also many patients without etiologic causes complain of globus sensation. The authors performed a study that evaluate association between oral water intake and symptoms of globus sensation on the basis of a belief that pharyngeal dehydration due to lack of oral water intake causes globus sensation. MATERIALS AND METHODS: A survey using visual analogue scale to evaluate symptoms was performed with 73 patients with globus pharyngeus. RESULTS: Patients who drink water less than 500 mL per day (p=0.04) and less than five times per day (p=0.02) were improved after 6 months due to education and doctor's recommendation. CONCLUSION: Frequent and enough water intake should be recommended to resolve symptoms of globus sensation.
Dehydration
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Drinking*
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Education
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Esophageal Motility Disorders
;
Foreign Bodies
;
Humans
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Laryngopharyngeal Reflux
;
Pharynx
;
Sensation
;
Water*
7.The Effect of Steroid Therapy for Idiopathic Unilateral Vocal Cord Palsy
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2019;30(2):107-111
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.
8.A Case of Tracheal Granuloma Removal using Potassium-Titanyl-Phosphate Laser
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2020;31(2):92-95
Tracheal granuloma, the most commonly reported sequela of pediatric tracheotomy. A variety of techniques are available for the management of tracheal granuloma. Potassium-titanyl-phosphate (KTP) laser has been previously established as an acceptable technique for removal of laryngeal surgery, which emits a green light with a wave length of 532 nm, which is well-absorbed by hemoglobin and can coagulate and vaporize tissue. The ability to deliver laser energy through a flexible glass fiber makes the technique convenient for use with a rigid bronchoscope, overcoming problems with intraluminal access encountered with earlier attempts at CO2 laser therapy for this problem. Another advantage of KTP laser is the avoidance of the risks and morbidity associated with an open procedure. We report our surgical technique KTP laser in the management of tracheal granuloma removal into the tracheostomy site. KTP laser is good tool for management of tracheal granuloma with low incidence of complications.
9.A Case of Voice Therapy for Patient Who Voice Changed after Total Thyroidectomy Using Contactless Voice and Speech Therapy Service Platform
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2021;32(1):43-47
Voice therapy is effective in many voice and speech disorders. However, patients have low accessibility to therapeutic facilities due to disease-unrelated reasons such as lack of time and pandemic of COVID-19. Contactless voice therapy could be an alternative and may helpful to all patients with voice and speech problems. We developed contactless voice and speech therapy program on the necessity of improving accessibility. Herein, we report the first case of voice therapy to 30 year-old female patient who complained voice change after total thyroidectomy using contactless voice and speech therapy service platform in Korea.
10.Analysis for Risk Factors and Effect of Vocal Hygiene Education in Patients of Vocal Polyp
Nayeon CHOI ; Dong Gyu KIM ; GilJoon LEE
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2021;32(1):24-28
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.