The Effect of Voice Therapy on Vocal Nodule Patients / 대한이비인후과학회지

OBJECTIVES: To evaluate objectively the effect and utility of voice therapy which uses acoustic analysis and aerodynamic assessment, in addition to psychoacoustic analysis, as an initial treatment for patients with vocal nodules. MATERIALS AND METHODS: Eighteen females and 14 males with vocal nodules were treated by voice therapy. The results of pre-treatment and post-treatment were compared with each other after the following analyses: acoustic analysis by measuring relative average pertubation (RAP) and shimmer; aerodynamic assessments by measuring S to Z ratio and maximum phonation time, and psychoacoustic analysis by using the GRBAS scales. RESULTS: All measurements of post-treatment improved significantly. The post-treatment results of children showed better improvement in shimmer, relative average pertubation and MPT, compared to those of adult patients. No significant difference in improvement could be found between male and female patients. CONCLUSION: Voice therapy may serve as one primary treatment modality in vocal nodule patients.

A Case of Management of Carotid Artery Rupture by Detachable Balloon Embolization / 대한이비인후과학회지

Carotid artery rupture ranks as the most dreaded among the head and neck surgery complications. Despite the well-documented risk of cerebral ischemia, operative carotid ligation has been the traditional management of last resort for carotid artery rupture. Over the past several years, however, the technique of endovascular occlusion of blood vessels has demonstated considerable promise in the management of carotid artery rupture. With the help of endovascular balloon occlusion, the authors managed a case of carotid artery rupture developed after the radiation therapy of laryngeal carcinoma and the salvage laryngectomy with neck dissection. Embolization on the right carotid artery was performed with detachable balloons and spiral coils after the carotid artery occlusion test. The patient did not show any complications of neurological function. The pharyngocutaneous fistula and skin defects were reconstructed with the use of pectoralis muscuocutaneous flap.