OBJECTIVES: We aimed to describe objectively the voice features of sulcus vocalis, thereby setting up some useful guidelines for its treatment. MATERIALS AND METHODS: The voices of thirty-seven sulcus vocalis pateints were analyzed. RESULTS: In the acoustic analysis, the fundamental frequency, jitter, and shimmer were significantly increased. Noise to harmonic ratio was also increased although it was not statistically significant. In the aerodynamic study, we found that maximal phonation time was decreased, whereas the mean air flow rate and subglottic pressure were increased. The glottic insuffiency on phonation, small vibratory mucosal wave and amplitude were frequently observed by videostroboscopy. CONCLUSION: The bowing of vocal fold edge results in an incomplete glottic closure during vibratory cycles. The increase in stiffness of the vocal fold edge during phonation results in small mucosal wave and small vibratory amplitude. Glottic insufficiency and stiffness of vibratory movement contribute to dysphonia of sulcus vocalis.
Acoustics ; Dysphonia ; Noise ; Phonation ; Vocal Cords ; Voice*

BACKGROUND AND OBJECTIVES: Sulcus vocalis is not an uncommon cause of breathy dysphonia. One of the treatment options may be the slicing mucosa surgical technique which has been met with some criticism. This study was designed to investigate the efficiency of slicing mucosa surgical technique for the treatment of sulcus vocalis with voice and stroboscopic analysis. MATERIALS AND METHODS: In 18 sulcus vocalis patients (10 males, 8 females), the slicing mucosa surgical technique was performed followed by voice therapy for 4 weeks. Postoperative parameters of perceptual analysis, acoustic analysis, aerodynamic study, and videostroboscopy after 6 months were compared with those of preoperative results. RESULTS: In the perceptual analysis, the rough component of dysphonia was improved in 71.4% of patients, whereas the breathy component was improved in 25.0% of patients. Fundamental frequency, jitter, shimmer of acoustic analysis were significantly improved, but MPT, MFR of aerodynamic study showed no changes. There was anatomical evidences of sulcus in 4 of 18 patients postoperatively. Videostroboscopy mucosa waves during phonation showed improvement in 72.2% of patients, but glottic insufficiencies showed improvement only in 38.9%. CONCLUSION: The results of this study indicate that the slicing mucosa surgical technique is effective in improving the anatomical abnormality and stiffness of vocal cord mucosa, but unsatisfactory in improving glottic insufficiency of sulcus vocalis. It may be helpful to develop a new or an additional technique that can simultaneously promote improved rnucosa vibration and glottic closure.
Acoustics ; Dysphonia ; Humans ; Male ; Mucous Membrane* ; Phonation ; Vibration ; Vocal Cords ; Voice*

BACKGROUND AND OBJECTIVES: Injury of recurrent laryngeal nerve is one of the major complications of thyroidectomy. One of the treatment options, which has met with some criticism, may be the repair of the injured nerve. This study was designed to investigate the efficiency of the neurorrhaphy of the injured recurrent laryngeal nerve with voice and videostroboscopic analysis. MATERIALS AND METHODS: For the injured recurrent laryngeal nerve, ansa hypoglossi-recurrent laryngeal nerve anastomosis has been performed in 6 patients, and direct end to end anastomosis has been performed in 4 patients. Postoperative parameters of perceptual analysis, acoustic analysis, aerodynamic study, and videostroboscopy after 6 months were compared with those of 11 patients whose recurrent laryngeal nerves were resected and left without neurorrhaphy. RESULTS: Perceptual breathy vocal quality and the aerodynamic parameters were better in anastomosed group, but there were no differences in the acoustic parameters. Medialization of vocal cord and the glottic closure was better in anastomosed group. No patient of the anastomosed group experienced dyspnea due to synkinesis. CONCLUSION: The results of this study indicates that the neurorrhaphy of injured recurrent laryngeal nerve is effective in improving the glottic closure, but unsatisfactory in achieving symmetric glottic tension and mucosa wave during phonation.
Acoustics ; Dyspnea ; Humans ; Laryngeal Nerves ; Mucous Membrane ; Phonation ; Recurrent Laryngeal Nerve* ; Synkinesis ; Thyroidectomy* ; Vocal Cords ; Voice*

BACKGROUND AND OBJECTIVES: Chronic otitis media with effusion is common in the pediatric population. One of the treatment options, which has been met with some criticism, may be the placement of tympanosotmoy tubes. This study was designed to analyze the outcome of children who have undergone tympanosotmoy tubes for the treatment of chronic otitis media with effusion. In addition, we investigated the efficiency of secondary tympanosotmoy tube insertion. MATERIALS AND METHODS: A retrospective study was carried out on 513 ears of children aged under 16 years and treated with tympanosotomy tubes. We documented the resolution rate of effusion, duration in situ of the tubes, prognostic factors, and the rate of complications. We also compared the treatment outcomes of the use of the secondary tympanosotomoy tube with that of the primary tube. RESULTS:The resolution rate of effusion was 87.1% and 70.0% for the primary tubes and the secondary tubes, respectively. The duration in situ of the secondary tube was shorter than that of the primary tube. The rates for complications of using tympaonosotomy tubes such as otorrhea, perfroation, cholesteatoma were relatively low. There were no significant differences between the complication rates of the primary and the secondary tympaonsotmoy tubes. CONCLUSION: This study indicates that the use of tympanosotomy tube is effective in treating chronic otitis media with effusion in children. The complication rates of' the secondary tube for recurred or persisted effusion after extrusion of the primary tube are low enough to support further use of this method of therapy.
Child* ; Cholesteatoma ; Ear ; Humans ; Middle Ear Ventilation* ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Retrospective Studies

There are several options for the management of patients with locally recurred nasopharyngeal carcinoma after irradiation. Many patients can benefit from reirradiation but the complications of high dose irradiation for the second time are often severe and unbearable. In some patients, the recurred lesion may persist even after the reirradiation. Obtaining an adequate exposure of the nasopharynx for an oncologic surgical procedure has been challenging because of its surgical inaccessibility. However, improvements in the surgical approaches to the nasopharynx and paranasopharynx have been made in recent years. Two illustrative cases, in which we performed salvage surgery, are presented in this article. Using the maxillary swing approach, we removed the recurrent nasopharyngeal tumor in a 43 year old female patient. The reassembly of the osseous and soft tissues was not difficult and the associated morbidity was acceptable. In a 19 year old male patient, subtemporal-preauricular infratemporal fossa approach was performed with low morbidity for the removal of tumor recurred at the pterygopalatine fossa.
Adult ; Female ; Humans ; Male ; Nasopharynx ; Pterygopalatine Fossa ; Young Adult

Organizing hematomas are rare benign tumors and appear as forms of mass which is composed of neovascularization with organizing fibrous tissue in hematoma. There have been sporadic reports of the organizing hematoma not only in soft tissue but also in brain, spinal cord, lung, and maxillary sinus. We report a case of organizing hematoma that was restricted in the nasal cavity without inclusion of the paranasal sinus. This is the first article describing the organizing hematoma of the nasal septum. We present this case with a review of literature.
Brain ; Hematoma ; Lung ; Maxillary Sinus ; Nasal Cavity ; Nasal Septum ; Spinal Cord

Radiation therapy is an effective cancer treatment modality as a primary treatment in early cancer and as an adjuvant treatment in advanced cancer, especially in head and neck lesions, but it also causes irreversible chronic damages to overlying normal tissues that may lead to wound complications. As well, at the microscopic level, radiation injury causes both stasis and occlusion of small vessels. Therefore, surgical reconstruction of previously-irradiated lesions in the head and neck poses a great problem. Fifth-six patients with head and neck lesions underwent 57 microsurgical reconstructions between 1990-1998. Thirteen patients were irradiated before surgery. The previous radiation dose was 30-75.6 Gy. The free tissue transfer was successful in 52 of the 57 microsurgical reconstructions(91.2%). The success rate was 92.3%(12/13) in previously-irradiated patients and 90.9%(40/44) in nonirradiated patients. Postoperative complications, such as flap loss, fistula, and infection, developed in 4 irradiated patients and 8 nonirradiated patients. Overall complication rate was 30.8%(4/13) in previously-irradiated patients and 18.2%(8/44) in nonirradiated patients. Although the failure rate of previously-irradiated patients was higher than that of nonirradiated patients, there was no statistically significant difference between them. Thus, free tissue transfers in patients with previously-irradiated head and neck lesions are suitable for one-stage reconstruction.
Fistula ; Head* ; Humans ; Neck* ; Postoperative Complications ; Radiation Injuries ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: Surfactant protein A (SP-A) which plays a role in the innate host defense of lung is also expressed in Eustachian tube. However the genes underlying the susceptibility to otitis media with effusion (OME) are known insufficiently. The current study attempts to evaluate the difference in the allele distribution of SP-A1 and SP-A2 between normal subjects and subjects with otitis media with effusion. SUBJECTS AND METHOD: PCR-cRFLP-based methodology was used to detect SP-A genotypes in the 38 children with OME, and in the 55 normal newborns for control. RESULTS: The frequencies of specific genotypes such as 6A(2), 1A(2) were increased in OME group, but the frequency of 6A3 was increased in control group. CONCLUSION: It is presumed that SP-A alleles may be inductive (6A(2), 1A(2)) or protective (6A(3)) factors for OME. Specific genoytypes of SP-A may be an important determinant for the predisposition to OME.
Alleles* ; Child ; Eustachian Tube ; Genotype ; Humans* ; Infant, Newborn ; Lung ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Pulmonary Surfactant-Associated Protein A*

Anterior cervical approaches to the cervical spine have been widely and safely used in spine surgery in recent years; however, they also have posed some otorhinolaryngological complications. We present a case of suspension laryngoscope assisting in the removal of a cervical screw. The patient was a 63-years-old man who was operated on traumatic cervical herniated disc. Surgical interference included C5 corpectomy, iliac bone autograft, anterior cervical fusion at C4-C6 level using an anterior cervical plate and screws. Five years later, he presented a foreign body sensation in the neck and odynophagia. The laryngoscopic exam showed the medial wall of the right pyriform sinus protrusion and the migration of an upper screw was observed in plain films and computed tomography of the cervical spine. The suspenson laryngoscope and C-arm fluoroscope were used for the transpharyngeal screw removal. The removal of the screw in question was successful with no complications. We report this case with a review of the literature.
Bone Screws ; Foreign Bodies ; Humans ; Intervertebral Disc Displacement ; Laryngoscopes ; Laryngoscopy ; Neck ; Pyriform Sinus ; Sensation ; Spinal Fusion ; Spine

BACKGROUND AND OBJECTIVES: Acetic acid is not uncommon suicidal material and it can cause serious laryngitis. The purpose of this study was to investigate the clinical characteristics, proper management, and clinical course of laryngitis induced by acetic acid. SUBJECTS AND METHOD: We analyzed the medical records of 39 patients with acetic acid ingestion from 1996 to 2006, retrospectively. RESULTS: Flexible fiberoptic laryngoscopy showed supraglottic laryngeal edema or mucosal ulcer with narrowed airway in 15 cases (38.5%). More common reason of ingestion was suicidal attempt than accidental exposure. There was no significant correlation between severity and the amount of ingestion, or the reason of ingestion. Eight patients needed orotracheal intubation for airway management, but no emergency tracheotomy was imperative. Most laryngeal lesions were relieved by supportive care within 2 weeks. CONCLUSION: Acetic acid laryngitis could narrow airway, and could be resolved by supportive management. Flexible fiberoptic laryngoscopy was useful in evaluating laryngeal involvement and severity.
Acetic Acid ; Airway Management ; Eating ; Emergencies ; Humans ; Intubation ; Laryngeal Edema ; Laryngitis ; Laryngoscopy ; Medical Records ; Retrospective Studies ; Tracheotomy ; Ulcer