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경부 굴곡변화 및 경부근이 pitch 조절에 미치는 영향
홍기환,김영중,정경호,김영기 대한후두음성언어의학회 1994 대한후두음성언어의학회지 Vol.5 No.1
The vocal pitch is controlled by the tension, mass, and length of the vocal fold. It is well known that cricothyroid approximation raises the vocal pitch by simulating the contraction of the cricothyroid muscle, and there were so many reports that have noted a relationship between cricothyroid distance and pitch control, but there does not seem to be any single generally accepted theory to account for this connection. It is generally known that the strap muscles are active during low and falling Fo, and the suprahyoid muscles are active during high and raising Fo. These findings can be related to a general picture of the motion of the larynx during changes in Fo, the cricothyroid joint would tend to lengthen the vocal folds, as the larynx moves up and forward, and relax them as it moves back and down. In this study, we suggest that the relationship between anterior cricothyroid distance and fundamental frequency of the larynx was so complex according to the level of larynx and vertebral curvature. The higher the level of larynx, the wider the cricothyoid distance, but there is more greater fundamental frequency even though more wide cricothyroid distance. This phono-menon seems to be due to the multifactors, especially the vertical tension of the conus elasticus or the change of cricothyroid articulation. It is generally known that the crocothyoid and vocal is muscles are very closely related to pitch elevation, but sternohyoid muscle seems to be more closely related to pitch lowering. By this electromyographic studies, the sternohyoid muscle have dual activity to pitch control, increased activity during the low fundamental frequency and falling pitch, but also increased activity during the higher fundamental frequency and raising pitch at least in this study.
성문하 기관 및 기관누공 협착증에 대한 팽창성 금속 스텐트의 문제점
홍기환,정경호,김중호,한영민 대한기관식도과학회 1996 大韓氣管食道科學會誌 Vol.2 No.2
To evaluate the clinical effectiveness of expandable metallic stents, the stents were implanted under endoscopic guidance with local anesthesia or general anesthesia for maintenance of the constructed subglottic space of trachea. The nine patients with respiration difficulty were subjected for expandable stents. The stenosis of upper airway were due to the framework problem of subglottic trachea and tracheostoma after total laryngectomy. Stents were constructed of 0.4 m stainless steel win in a zigzag configuration of 8 bends. A single stent was 20 m in diameter when fully expanded and 20 mm long. The stents were placed accurately to the stenotic site and followed to the 5 month after stent placement. The stenotic area became narrowed with overgrowing of granuloma in all patients and the metallic stents were removed and the stenotic area reconstructed surgically. As conclusion, this technique for the treatment of the subglottic trachea showed simple and safe, but highly recurred due to overgrowing of granuloma. We suggest that the expandable metallic stent is not encouraging in this study.
홍기환,양윤수 대한기관식도과학회 1997 大韓氣管食道科學會誌 Vol.3 No.2
The records of 18 patients with squamous cell carcinoma of the tongue and floor of mouth treated surgically were reviewed. Surgical approaches, staging, treatment modalities, recurrence and vital status were evaluated. The distrubutions of involved sites were tongue(9 cases) and mouth floor(9 cases). Patients were treated by surgery primarily, combined chemotherapy and radiation, and by surgical salvage in the failure cases of radiation and chemotherapy. All ipsilateral necks of mouth floor cancer and advanced tongue cancer were treated with neck dissection. Cases of early tongue cancer could be excised with transoral route, and advanced cases needed transmandibular approach. Whereas, majorites of mouth floor cancer needed transmandibular approach, and other cases could be excised transoral and pull-through approaches. In the recontructions, we used primary closure, pectoralis major myocutaneous flap, forearm free flap, fibular osteocutaneous flap and skin graft. One year survival rate was 93% and 2 year survival rate was 60%.
홍기환,박정훈,김원,김창현,Hong, Ki-Hwan,Park, Jung-Hoon,Kim, Won,Kim, Chang-Hyun 대한후두음성언어의학회 1999 대한후두음성언어의학회지 Vol.10 No.2
Background and Objectives : The intracordal cysts are more increasingly diagnosed and treated due to advanced laryngeal stroboscopy and laryngeal microsurgical technique. The intracordal cysts are frequently misdiagnosed as vocal polyp or nodule The purpose of this study is to evaluate clinical features of intracordal cysts. Materials and Methods : In the present series, 83 cases of the intracordal cysts treated with laryngeal microsurgery are reported. The intracordal cysts are diagnosed preoperatively with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with laryngeal microsurgical findings and biopsies. Results : Intracordal cysts are 83 of 1900 patients treated with laryngeal microsurgery(4.4%)-ductal cysts are 56 cases and epidermoid cysts are 27 cases. Intracordal cysts are more frequent in women, forties and the frequent site is an anterior third of the true vocal cord. With the indirect laryngoscopic examination, the ductal cysts are frequently misdiagnosed as vocal polyps or nodules but the epidermoid cysts are relatively easily diagnosed. The etiologic factors of the intracordal cysts are suspected as voice abuse and upper respiratory infection. The degree of postoperative voice satisfaction is similar to that of the vocal polyps. Conclusion : Intracordal cysts are frequently misdiagnosed as polyps or nodules, therefore preoperative stroboscopic findings and laryngeal microsurgical findings is important. An ideal treatment is to enucleate the cysts avoiding rupture of cyst and injury of lamina propria of the vocal cord.