1.Artificial Intelligence for Clinical Research in Voice Disease
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2022;33(3):142-155
Diagnosis using voice is non-invasive and can be implemented through various voice recording devices; therefore, it can be used as a screening or diagnostic assistant tool for laryngeal voice disease to help clinicians. The development of artificial intelligence algorithms, such as machine learning, led by the latest deep learning technology, began with a binary classification that distinguishes normal and pathological voices; consequently, it has contributed in improving the accuracy of multi-classification to classify various types of pathological voices. However, no conclusions that can be applied in the clinical field have yet been achieved. Most studies on pathological speech classification using speech have used the continuous short vowel /ah/, which is relatively easier than using continuous or running speech. However, continuous speech has the potential to derive more accurate results as additional information can be obtained from the change in the voice signal over time. In this review, explanations of terms related to artificial intelligence research, and the latest trends in machine learning and deep learning algorithms are reviewed; furthermore, the latest research results and limitations are introduced to provide future directions for researchers.
2.Tracheostomy Performed by a Head and Neck Surgeon Under the Supervision of an Intensive Care Unit Specialists in the COVID-19 Era: A Retrospective Analysis
Won Ho HAN ; Yun Im LEE ; Sunhwa BAEK ; Jungirl SEOK
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2022;33(2):97-102
Background and Objectives:
Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist.Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period.
Results:
Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients.
Conclusion
The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.
3.Recent Trends in the Incidence of Salivary Gland Malignancies
Jungirl SEOK ; Eun Hye PARK ; Kyu-Won JUNG ; Jae Won CHANG
Korean Journal of Head and Neck Oncology 2022;38(2):1-5
Due to the low incidence and histologic diversity of salivary gland cancer, analyzing the incidence of salivary gland cancer is necessary to understand the macroscopic aspects. We intend to investigate the international trend of the reported incidence rate of salivary gland cancer. Using the Korea Central Cancer Registry data, the domestic change in the incidence rate was examined. As a result, a significant increasing trend was confirmed, consistent with the United States and Japan trends. The etiology of the change is unclear, and various factors that may influence the direction are reported. Additional research is needed to understand the pathophysiology of salivary gland cancer, and further efforts are required to understand salivary gland cancer.
4.A Case of Posterior Tracheal Wall Rupture During Tracheostomy Treated With Sternocleidomastoid Muscle Reinforcement
In Kyeong CHOI ; Do Hyun CHUNG ; Do Won KIM ; Jungirl SEOK
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(11):591-595
A posterior tracheal wall rupture is a rare but life-threatening complication of tracheostomy. Several flaps based on the sternocleidomastoid (SCM) muscle, which has sufficient length and abundant blood supply, are utilized for the reconstruction of tracheal defects. We discuss here a case of a 71-year-old male with multiple organ failure and mental retardation, with posterior tracheal wall damage that had occurred during tracheostomy tube insertion. When planning the repair of the wound, additional reinforcement was necessary due to saliva leakage secondary to decreased consciousness. Direct suturing was followed by the reinforcement of SCM muscle transposition, which was conducted through cervical and endoscopic approach.
5.A Case of Posterior Tracheal Wall Rupture During Tracheostomy Treated With Sternocleidomastoid Muscle Reinforcement
In Kyeong CHOI ; Do Hyun CHUNG ; Do Won KIM ; Jungirl SEOK
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(11):591-595
A posterior tracheal wall rupture is a rare but life-threatening complication of tracheostomy. Several flaps based on the sternocleidomastoid (SCM) muscle, which has sufficient length and abundant blood supply, are utilized for the reconstruction of tracheal defects. We discuss here a case of a 71-year-old male with multiple organ failure and mental retardation, with posterior tracheal wall damage that had occurred during tracheostomy tube insertion. When planning the repair of the wound, additional reinforcement was necessary due to saliva leakage secondary to decreased consciousness. Direct suturing was followed by the reinforcement of SCM muscle transposition, which was conducted through cervical and endoscopic approach.
6.A Case of Posterior Tracheal Wall Rupture During Tracheostomy Treated With Sternocleidomastoid Muscle Reinforcement
In Kyeong CHOI ; Do Hyun CHUNG ; Do Won KIM ; Jungirl SEOK
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(11):591-595
A posterior tracheal wall rupture is a rare but life-threatening complication of tracheostomy. Several flaps based on the sternocleidomastoid (SCM) muscle, which has sufficient length and abundant blood supply, are utilized for the reconstruction of tracheal defects. We discuss here a case of a 71-year-old male with multiple organ failure and mental retardation, with posterior tracheal wall damage that had occurred during tracheostomy tube insertion. When planning the repair of the wound, additional reinforcement was necessary due to saliva leakage secondary to decreased consciousness. Direct suturing was followed by the reinforcement of SCM muscle transposition, which was conducted through cervical and endoscopic approach.
7.A Case of Posterior Tracheal Wall Rupture During Tracheostomy Treated With Sternocleidomastoid Muscle Reinforcement
In Kyeong CHOI ; Do Hyun CHUNG ; Do Won KIM ; Jungirl SEOK
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(11):591-595
A posterior tracheal wall rupture is a rare but life-threatening complication of tracheostomy. Several flaps based on the sternocleidomastoid (SCM) muscle, which has sufficient length and abundant blood supply, are utilized for the reconstruction of tracheal defects. We discuss here a case of a 71-year-old male with multiple organ failure and mental retardation, with posterior tracheal wall damage that had occurred during tracheostomy tube insertion. When planning the repair of the wound, additional reinforcement was necessary due to saliva leakage secondary to decreased consciousness. Direct suturing was followed by the reinforcement of SCM muscle transposition, which was conducted through cervical and endoscopic approach.
8.A Case of Posterior Tracheal Wall Rupture During Tracheostomy Treated With Sternocleidomastoid Muscle Reinforcement
In Kyeong CHOI ; Do Hyun CHUNG ; Do Won KIM ; Jungirl SEOK
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(11):591-595
A posterior tracheal wall rupture is a rare but life-threatening complication of tracheostomy. Several flaps based on the sternocleidomastoid (SCM) muscle, which has sufficient length and abundant blood supply, are utilized for the reconstruction of tracheal defects. We discuss here a case of a 71-year-old male with multiple organ failure and mental retardation, with posterior tracheal wall damage that had occurred during tracheostomy tube insertion. When planning the repair of the wound, additional reinforcement was necessary due to saliva leakage secondary to decreased consciousness. Direct suturing was followed by the reinforcement of SCM muscle transposition, which was conducted through cervical and endoscopic approach.
9.Deep-Learning-Based Segmentation of Predefined Chunks in Connected Speech: A Retrospective Analysis
Jae Yeong KIM ; Jungirl SEOK ; Jehyun LEE ; Jeong Hoon LEE ; Tack-Kyun KWON
Journal of the Korean Society of Laryngology Phoniatrics and Logopedics 2024;35(1):15-23
Background and Objectives:
In institutional settings, manually segmenting connected speech is a time-consuming and labor-intensive process. This study aims to develop a deep-learning model for automating this process, evaluating its accuracy, and determining the minimum dataset size for effective performance.Materials and Method Voice data from 524 individuals with pathological conditions and 502 individuals with normal conditions, totaling 1026 samples, were used. Each voice sample had 17 chunks, including a “summer” sentence (15 chunks) and vowels /α/ and /i/. The deep-learning model employed in this study is based on the multi-layer perceptron-mixer architecture. This study evaluated performance using the Intersection over Union (IoU) metric, commonly employed in artificial intelligence-based image detection for chunk segmentation.
Results:
The accuracy of chunk identification at the frame level was 96.47%. Using IoU metrics, chunk segmentation accuracy was 98.15% at IoU ≥0.6, 96.03% at IoU ≥0.7, and 89.78% at IoU ≥0.8. Optimal dataset size exploration indicated that more than 700 connected speech datasets were needed for successful training, maintaining F1-scores up to 95% at IoU ≥0.7.
Conclusion
The artificial intelligence model is suitable for the development of an automated system that efficiently divides segments in the institutional collection of voice data. This suggests its potential utility in advancing voice research using connected speech.
10.Endoscopically Applied Biodegradable Stent in a Rabbit Model of Pediatric Tracheomalacia
Ji Suk CHOI ; Jungirl SEOK ; Min Rye EOM ; Eungee JUNG ; Su A PARK ; Sang Min JOO ; Yeo Jin JUN ; Kil Won SON ; Seong Keun KWON
Clinical and Experimental Otorhinolaryngology 2021;14(3):328-337
Objectives:
. A polydioxanone (PDO) stent was developed to treat tracheomalacia in pediatric patients. However, its safety and efficacy need to be verified in animal studies before clinical trials in patients can be conducted. This study evaluated the safety and efficacy of a PDO stent in normal and tracheomalacia-model rabbits.
Methods:
. In total, 29 New Zealand white rabbits were used: 13 for evaluating the biocompatibility of the PDO stent in normal rabbits and 16 for the creation of a tracheomalacia model. The tracheomalacia model was successfully established in 12 rabbits, and PDO stents were placed in eight of those rabbits.
Results:
. The PDO stent was successfully positioned in the trachea of the normal rabbits using an endoscopic approach, and its degradation was observed 10 weeks later. The stent fragments did not induce distal airway obstruction or damage, and the mucosal changes that occurred after stent placement were reversed after degradation. The same procedure was performed on the tracheomalacia-model rabbits. The survival duration of the tracheomalacia rabbits with and without stents was 49.0±6.8 and 1.0±0.8 days, respectively. Thus, the PDO stent yielded a significant survival gain (P=0.001). In the tracheomalacia rabbits, stent degradation and granulation tissue were observed 7 weeks after placement, leading to airway collapse and death.
Conclusion
. We successfully developed a PDO stent and an endoscopic guide placement system. The degradation time of the stent was around 10 weeks in normal rabbits, and its degradation was accelerated in the tracheomalacia model. The mucosal changes associated with PDO stent placement were reversible. Placement of the PDO stent prolonged survival in tracheomalacia-model rabbits.