성대주입술을 결합한 음성치료의 효과 연구

The Study of Combined Voice Therapy with Intralaryngeal Injection

  • 안철민 (프라나이비인후과 음성치료센터) ;
  • 정화원 (프라나이비인후과 음성치료센터) ;
  • 신정은 (프라나이비인후과 음성치료센터)
  • 투고 : 2017.02.24
  • 심사 : 2017.05.02
  • 발행 : 2017.06.30

초록

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.

키워드

참고문헌

  1. Ahn CM. Functional Dysphonia and Voice Therapy. 1st ed. Seoul, Korea: Dae Han Eui Hak Seo Jeok;2004. p.123-30.
  2. Czerwonka L, Jiang JJ, Tao C. Vocal nodules and edema may be due to vibration-induced rises in capillary pressure. Laryngoscope 2008;118(4):748-52. https://doi.org/10.1097/MLG.0b013e31815fdeee
  3. Lee JY, Lee JH, Choi JI, Lee SH, Jin SM. Usefulness of voice therapy on vocal nodules in professional voice users treated with steroid injection. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(1):32-7. https://doi.org/10.3342/kjorl-hns.2014.57.1.32
  4. Ahn CM, Park JW, Lee JH, Lee YB, Park HJ. Therapeutic effects of voice therapy on functional voice disorders. Korean J Otolaryngol 996;39(2):288-94.
  5. Holmberg EB, Hillman RE, Hammarberg B, Sodersten M, Doyle P. Efficacy of a behaviorally based voice therapy protocol for vocal nodules. J Voice 2001;15(3):395-412. https://doi.org/10.1016/S0892-1997(01)00041-8
  6. McCrory E. Voice therapy outcomes in vocal fold nodules: a retrospective audit. Int J Lang Commun Disord 2001;36 Suppl:19-24. https://doi.org/10.3109/13682820109177852
  7. Pyo HY, Kim MS, Choi HS. The efficiency of voice therapy for the patients with vocal nodules. J Korean Logo Phon 1997;8(2):178-84.
  8. Smith BE, Kempster GB, Sims HS. Patient factors related to voice therapy attendance and outcomes. J Voice 2010;24(6):694-701. https://doi.org/10.1016/j.jvoice.2009.03.004
  9. Boone DR. Dismissal criteria in voice therapy. J Speech Hear Disord 1974;39(2):133-9. https://doi.org/10.1044/jshd.3902.133
  10. Hillman RE, Holmberg EB, Perkell JS, Walsh M, Vaughan C. Objective Assessment of Vocal HyperfunctionAn Experimental Framework and Initial Results. Journal of Speech, Language, and Hearing Research, 1989;32(2):373-92. https://doi.org/10.1044/jshr.3202.373
  11. Titze, Ingo R. "Mechanical stress in phonation." Journal of Voice 1994;8(2):99-105. https://doi.org/10.1016/S0892-1997(05)80302-9
  12. Jiang J, Titze I. Measurements of vocal fold pressure and impact stress in human subjects. J Voice 1994;8:132-45. https://doi.org/10.1016/S0892-1997(05)80305-4
  13. Boone DR, McFarlane SC, Von Berg SL, Zraick RI. The voice and voice therapy;2009.
  14. Lee SH, Yeo JO, Choi JI, Jin HJ, Kim JP, Woo SH, et al. Local steroid injection via the cricothyroid membrane in patients with a vocal nodule. Archives of Otolaryngology-Head &Neck Surgery 2011;137(10):1011-6. https://doi.org/10.1001/archoto.2011.168
  15. Hapner E, Portone-Maira C, Johns MM. A study of voice therapy dropout. Journal of Voice 2009;23(3):337-40. https://doi.org/10.1016/j.jvoice.2007.10.009
  16. Boone DR, McFarlane SC, Von Berg SL. Functional voice disorders. The voice and voice therapy. 8th ed International Edition. Boston: Pearson;2010. p.113-32.
  17. Homicz MR, Watson D. Review of injectable materials for soft tissue augmentation. Facial Plat Surg 2004;20:21-9. https://doi.org/10.1055/s-2004-822955
  18. Kwon TK. Vocal fold injection, In:The Korean society of laryngology, phoniatrics and logopedics, Understanding of laryngology voice, speech and swallowing.1st ed. Seoul:Iljogak;2012. p.606-25.