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Huge Subglottic Polyp Treated with Tracheotomy and Laryngofissure.

Yong Tae HONG ; Cha Dong YEO ; Ki Hwan HONG

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):52-54.

Vocal polyps are benign laryngeal lesions which arise from the Reinke's space abd hoarseness is the most common symptom. However, airway compromised is rarely presented in the vocal polyp. A rare case of large subglottic polyp causing dyspnea is reported. Tracheostomy was performed under local anesthesia and then the mass was resected under general anesthesia using a laryngofissure approach. The dyspnea and hoarseness disappeared after surgery immediately. The histopathological findings indicated a diagnosis of vocal cord polyp with chronic inflammatiuon. We consider that tracheostomy is the safest and most useful procedure to guarantee the upper airway in cases of large vocal polyp showing dyspnea. We hereby report a case of huge subglottic polyp in which a tracheostomy and laryngofissure was required for removing the subglottic mass successfully.
Anesthesia, General ; Anesthesia, Local ; Diagnosis ; Dyspnea ; Hoarseness ; Polyps* ; Tracheostomy ; Tracheotomy* ; Vocal Cords

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A Case of Laryngeal Candidiasis Presented as Laryngeal Leukoplakia.

Ki Yong CHOI ; Young Hwan KIM ; Na Hye MYONG ; Sang Joon LEE

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):48-51.

Candida exists in the oral cavity as normal flora, which is cultured in 7% of the population. And the development of candidiasis is usually related to the systemic or local immunosuppressed status such as diabetes, long-term antibiotics, steroid, radiation therapy or chemotherapy. However, isolated laryngeal candidiasis in immunocompetent patients is a rare entity with fewer than 40 cases reported in the world. Symptoms of laryngeal candidiasis are variable such as hoarseness, dysphagia, or odynophagia according to its extent, but it has clinical importance because of its resemblance with laryngeal premalignant or malignant lesions. Diagnosis is made by biopsy under direct laryngoscopy with special staining to identify the hyphae. In this article, we report a case of laryngeal candidiasis presented as leukoplakia localized on vocal fold with literature reviews.
Anti-Bacterial Agents ; Biopsy ; Candida ; Candidiasis* ; Deglutition Disorders ; Diagnosis ; Drug Therapy ; Hoarseness ; Humans ; Hyphae ; Laryngoscopy ; Larynx ; Leukoplakia* ; Mouth ; Vocal Cords

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A Case of Esophageal Achalasia Misconceived as Laryngopharyngeal Reflux Disease.

Seung Ho NOH ; Yong Woo LEE ; Jin Su PARK ; Sang Hyuk LEE

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):43-47.

Laryngopharyngeal reflux disease (LPRD) is common in laryngologic practice. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. Major symptoms of LPRD include hoarseness, cough, reflux symptom and mild dysphagia. Even though LPRD is common, its diagnosis may be difficult, because its symptoms are nonspecific and the laryngeal findings are not always associated with symptom severity. In Recent study, 66.4% of Patient who has LPRD also associated with esophageal motility disorders. Esophageal achalasia is a disease of unknown etiology characterized by an absence of peristalsis in the body of esophagus and nonrelaxing hypertension of the lower esophageal sphincter. Common cause is loss of ganglion cells in Auerbachs plexus. The classic triad of symptoms in achalasia includes dysphagia, regurgitation and weight loss. LPRD and esophageal achalasia have similar symptoms but have different treatment of choice. The Differentiation diagnosis of theses disease is important and should be established by history, radiologic examination and endoscopic examination. We recently assessed a 59-year-old female patient who complained of an epigastric pain, dysphagia and chronic cough. LPRD was initially diagnosed on Laryngoscopic examination and Reflux Symptom Index, but patient was not relieved of any symptoms after treatment of Proton Pump Inhibitor for 3 months. After high resolution manometry, esophageal achalasia was finally diagnosed. We report this case regarding the diagnosis and treatment with review of literatures because we have to think about esophageal motility disorders as a differential diagnosis in laryngology.
Cough ; Deglutition Disorders ; Diagnosis ; Diagnosis, Differential ; Esophageal Achalasia* ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower ; Esophagus ; Female ; Ganglion Cysts ; Hoarseness ; Humans ; Hypertension ; Korea ; Laryngopharyngeal Reflux* ; Manometry ; Middle Aged ; Myenteric Plexus ; Otolaryngology ; Peristalsis ; Proton Pumps ; Weight Loss

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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 ; Drinking* ; Education ; Esophageal Motility Disorders ; Foreign Bodies ; Humans ; Laryngopharyngeal Reflux ; Pharynx ; Sensation ; Water*

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Treatment Result of Proton Pump Inhibitor, Steroid Inhaler and Botulinum Tonxin Injection for Contact Granuloma.

Hyoung Min PARK ; Na Rae OH ; Min Kwan BAEK ; Dong Young KIM ; Joo Hyun WOO

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):32-37.

BACKGROUND AND OBJECTIVES: This study evaluated the efficacy of combination therapy of proton pump inhibitor (PPI) and steroid inhaler (SI), with or without botulinum toxin injection (BTX) for contact granuloma. SUBJECTS AND METHODS: Fourteen contact granuloma patients were enrolled in this study. Combination therapy of PPI and SI were used for the first line treatment. When combination therapy was not effective, BTX was performed as the second method. Treatment results were recorded as responsible or non-responsible. Farwell grade, size, history of voice abuse, gender, and reflux finding score (RFS) were compared between responsible group and non-responsible group. RESULTS: Initial response rate was 28.6% after treatment of PPI and SI. BTX was performed on three un-responsible patients. After BTX injection, three patients had complete remission of granuloma. Final response rate was 50.0%. Un-responsible group had significantly higher RFS than responsible group. CONCLUSION: The efficacy of PPI and SI was limited for contact granuloma in this study. Botulium toxin injection was recommended in early phase when PPI and SI did not effective for contact granuloma. Prospective studies evaluating the effects of PPI and SI are warranted.
Botulinum Toxins ; Granuloma* ; Humans ; Methods ; Nebulizers and Vaporizers* ; Prospective Studies ; Proton Pumps* ; Protons* ; Vocal Cords ; Voice

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The Study of Combined Voice Therapy with Intralaryngeal Injection.

Cheol Min AHN ; Hwa Won JUNG ; Jung Eun SHIN

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):25-31.

BACKGROUND AND OBJECTIVES: Though voice therapy is proven to be effective in academia, treatment results and satisfaction level are inconsistent in clinics. The inconsistency may rise from diverse vocal cords misuse patterns in patient population as they suffer from different diseases or have bad phonation habits. In order to overcome the limitation, we uniformized patients' vocal cords with injection laryngoplasty prior to voice therapy. The efficacy of voice therapy and consistency in treatment results after injection laryngoplasty were assessed. MATERIALS AND METHODS: Patients diagnosed with vocal nodules were either treated with injection laryngoplasty followed by voice therapy (combined treatment group) or voice therapy only (voice therapy group). Each group consisted of 15 patients. Acoustic measures (jitter, shimmer, NHR), aerodynamic measures (MPT, Psub, MAFR), and subjective auditory conscious measures (K-VHI, K-VRQOL) between two groups were analyzed. RESULTS: After treatments, both groups improved in terms of acoustic, aerodynamic, and subjective auditory conscious measures compared to pre-treatment. Combined treatment group had statistically significantly greater improvement in shimmer, P in K-VHI, and PF in K-VRQOL compared to voice therapy group. CONCLUSION: Injection laryngoplasty treatment prior to voice therapy synergizes in treating patients compared to voice therapy only.
Acoustics ; Humans ; Laryngoplasty ; Phonation ; Vocal Cords ; Voice*

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Classification and Management in Patients with Laryngomalacia.

Gi Cheol PARK

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):20-24.

Laryngomalacia is the most common congenital anomaly that causes inspiratory stridor and airway obstruction in the newborn. Symptoms begin to appear after weeks of age, become worse at 4-8 months, improve between 8-12 months, and usually heal naturally at 12-18 months. Despite these common natural processes, the symptoms of the disease can be very diverse and, in severe cases, require surgical treatment. The diagnosis can be made by suspicion of clinical symptoms and direct observation of the larynx with the spontaneous breathing of the child. Typical laryngeal features include omega-shaped epiglottis, retroflexed epiglottis, short aryepiglottic fold, poor visualization of the vocal folds, and edema of the posterior glottis, including inspiratory supra-arytenoid tissue prolapse. In this review, we discuss the classification and treatment based on symptoms and laryngoscopic findings in patients with laryngomalacia.
Airway Obstruction ; Child ; Classification* ; Comorbidity ; Diagnosis ; Edema ; Epiglottis ; Glottis ; Humans ; Infant, Newborn ; Laryngomalacia* ; Larynx ; Prolapse ; Respiration ; Respiratory Sounds ; Vocal Cords

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Standardization Voice Training Method for Professional Voice User Based on Traditional .

Chul Jun KIM

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):17-19.

Opera singers train their vocal organ to have a good timbre of voice. They train and train again to have a strong resonance, large range of voice, homogenous color of voice, a voice goes far and to avoid vocal disorder, etc. This article is analyzing from scientific and medical perspective. It could approach the secret of the great art of 400 years history - . Furthermore standardizing voice training method based on will facilitate to train, therapy and care the voice professional user and voice disorders.
Methods* ; Singing ; Voice Disorders ; Voice Training* ; Voice*

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Vocal Exercises for Reducing Vocal Damages Caused by Breathy Phonation in Pop Singing.

Miran YU

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):14-16.

Pop singers frequently use breathy voice to express diverse emotion. Such method is the major factor that divides vocalization in pop and classical music. Using breathy voice too much for a long time could make singer short-winded, which might cause the voice injured. In order to prevent the problem, singers need to find resonance balance between high notes and low notes and among vowels. Moreover, they should take more attention when producing resonance in consonants with much air flow. Along with finding resonance balance, if skilled at controlling the volume of voice, singers can use the breathy voice selectively at the desired part, adjusting close quotient freely. Through this kind of approach, pop singers can develope their unique style of vocalization and avoid the vocal damage.
Exercise* ; Methods ; Music ; Phonation* ; Singing* ; Voice

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The SLP's Perspectives for the Vocal Elites and Singing Voice.

Jae Yeon YOO

Journal of the Korean Society of Laryngology Phoniatrics and Logopedics.2017;28(1):11-13.

This article addresses the roles of the speech language pathologist (SLP) for singers who require prompt and effective treatment when a voice problem arises. The causes of voice problem are often vocal abuse/misuse/overuse, muscle tension dysphonia and inappropriate singing technique. The SLP should conduct voice counseling and voice assessment for maintaining healthy voice of singer constantly.
Counseling ; Dysphonia ; Muscle Tonus ; Singing* ; Voice*

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