• Title/Summary/Keyword: 발성장애

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Acoustic Analysis of Respiration and Phonation Method

  • 문영일;정성민;김문정
    • Proceedings of the KSLP Conference
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    • 1998.11a
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    • pp.180-180
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    • 1998
  • 목소리를 많이 사용하는 사람들에서 발생되는 음성장애는 대부분 잘못된 발성방법으로 인한 후두의 과긴장으로 인해 야기되는 것으로, 흡기 및 호기를 자발적으로 조절할 수 있는 호흡방법과 성대 및 주변 근육의 긴장을 줄이도록 하는 훈련하는 음성치료가 주된 치료 방법으로 대두되고 있다. 지금까지 음성치료의 효과는 주로 청음인지적(perceptual) 측면에서 많이 논의되어 왔으며 객관적인 자료는 아직까지 별로 없는 상태이다. 더욱이 호흡 및 발성 방법에 따른 음성 분석은 미진한 상황이다. (중략)

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A Case of Mutational Dysphonia Treated with Type III Thyroplasty (제3형 갑상연골성형술에 의한 변성발성장애의 치험 1례)

  • 최홍식;조창현;김광문
    • Proceedings of the KSLP Conference
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    • 1994.06b
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    • pp.90-90
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    • 1994
  • 변성발성장애(Mutational dysphonia)는 원인이 확실히 밝혀져 있지는 않지만, 변성기에 성호르몬의 작용에 의한 정상적인 후두의 발육이 제대로 이루어지지 않아서 발생되는 것으로 추정되고 있다. 임상 양상은 대개 성인 남자임에도 불구하고 병적으로 음성의 기본주파수(fundamental frequency)가 높아서 여자 목소리에 가깝게 들린다는 것을 주 증상으로 하고 있으며, 이학적 검사상 성대의 움직임은 정상이나, 성대의 두께가 얇거나, 성대의 길이가 짧고 긴장도가 증가되어 있는 것 같이 보인다. 음성치료를 시도해 볼 수 있으며, Isshiki가 제 3형 갑상연골성형술로 효과적으로 치료될 수 있다고 보고한 이래, 다수의 보고자들에 의해 시도되어 왔다. (중략)

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Effect of Radiation Therapy on Voice Parameters in Early Layngeal Cancer and Normal Larynx (방사선요법이 초기 후두암 및 정상후두의 음성지표에 미치는 영향)

  • 박한종;이인자;박영학;김민식;조승호
    • Proceedings of the KSLP Conference
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    • 1994.06b
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    • pp.88-88
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    • 1994
  • 초기후두암에 대한 방사선요법은 수술적 치료에 비하여 정상 후두기능 즉 발성 기능을 최대 한 보존할 수 있는 장점이 있다. 그러나 방사선 치료법은 병적 혹은 정상 후두조직에 섬유화, 점막부종 혹은 점액선 간소등의 변영을 초래할 수 있기 때문에 어느 정도의 음성장애를 유발하게 된다. 방사선요법이 후두의 발성기능에 미치는 영향을 알아보기 위하여 초기후두암 환자와 두경부암으로 인하여 정상후두에 방사선 조사를 받았던 환자 및 정상대조군 각 20명에 대하여 음향 및 공기역학적 음성검사를 시행하여 음성장애의 특성을 비교, 검토하였다. 초기 후두암 환자들에게 사는 방사선 치료 후 음성지표들이 관찰되었고, 정상후두에는 큰 영향을 미치지 않았다. (중략)

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A Follow-Up Case of Voice Changes in Acute COVID-19 Infection (급성 COVID-19 감염의 음성 변화 추적 관찰 1예)

  • Seung Jin, Lee
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.3
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    • pp.183-187
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    • 2022
  • Dysphonia is well known as one of the otolaryngological symptoms of coronavirus disease 2019 (COVID-19) infection. The vocal changes of the COVID-19 condition have been reported in terms of parameters of multi-dimensional voice assessment, including acoustic analysis, auditory-perceptual evaluation, and psychometric assessment. However, there has not been a daily followup study in patients with acute COVID-19 infection. In this study, a 41-year-old male performed daily voice recordings of vowel phonation and passage-reading tasks during the self-quarantine period of one week. Compared to the normal voice status of the prepandemic period, voice abnormalities peaked on day two after the diagnosis of COVID-19 infection and recovered after one week.

Comparison of Acoustic Parameters According to the Section of Analysis in Sustained Vowel Phonation (모음연장 음성 샘플의 분석 구간에 따른 음향학적 파라미터 비교)

  • Shin, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.269-274
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    • 2017
  • This study aimed to investigate the acoustic differences that occur in diverse sections of sustained vowel phonation, which is often used in an objective speech analysis of voice disorder patients. The subjects included 17 voice disorder patients (vocal nodules) and 12 normal individuals without any voice disorder. The participants' sustained vowel phonation of /a/ was divided into onset, middle, and offset, and the jitter, shimmer, and NHR in each section were analyzed using the MDVP(Multi-Dimensional Voice Program). The Friedman test and post hoc analysis were used. In the vocal nodules group, the jitter, shimmer and NHR were significantly higher in the off section of sustained vowel phonation than in the middle section, and there were no significant differences between the beginning and middle sections. In contrast, in the group of normal individuals, there were no significant differences between any of the sections. The values of the acoustic parameters according to the section of analysis in the sustained vowel phonation are different and the vocal in the end section is significantly more unstable than that in the middle section. The results of this study will be useful for selecting the sections to be analyzed in sustained vowel phonation and interpreting the results of the analysis.

Discussions on Auditory-Perceptual Evaluation Performed in Patients With Voice Disorders (음성장애 환자에서 시행되는 청지각적 평가에 대한 논의)

  • Lee, Seung Jin
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.3
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    • pp.109-117
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    • 2021
  • The auditory-perceptual evaluation of speech-language pathologists (SLP) in patients with voice disorders is often regarded as a touchstone in the multi-dimensional voice evaluation procedures and provides important information not available in other assessment modalities. Therefore, it is necessary for the SLPs to conduct a comprehensive and in-depth evaluation of not only voice but also the overall speech production mechanism, and they often encounter various difficulties in the evaluation process. In addition, SLPs should strive to avoid bias during the evaluation process and to maintain a wide and constant spectrum of severity for each parameter of voice quality. Lastly, it is very important for the SLPs to perform a team approach by documenting and delivering important information pertaining to auditory-perceptual characteristics in an appropriate and efficient way through close communication with the laryngologists.

A Case of Thyroarytenoid Myectomy with Selective Recurrent Laryngeal Nerve Section in Intractable Spasmodic Dysphonia: A Long-Term Follow-Up (난치성 연축성 발성장애 환자에서 갑상피열근 절제술 및 선택적 반회후두신경 절제술 1예: 장기 추적 관찰)

  • Lee, Yun Ji;An, You Young;Park, Ki Nam;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.35-38
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    • 2020
  • Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

The Effect of Voice Therapy Applying Self-Regulation Concepts on Dysphonia Patients (자기 조절 개념을 적용한 음성치료 기법이 발성장애 환자에게 미치는 효과)

  • Lee, Chang-Yoon;An, Soo-Youn;Son, Hee Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.15-20
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    • 2019
  • Background and Objectives : The goal of this study is to present a strategy for improving the self-regulation (SR) ability and facilitating the change of vocal behavior by applying voice therapy using the SR concept to the patients with vocal cord nodule and muscle tension dysphonia. Materials and Method : The subjects were 80 patients and 80 patients who were diagnosed with muscle tension dysphonia and vocal nodules. As a control group, the results were compared among patients with the same dysphonia without using SR strategies. The concept of SR before voice therapy was explained to the patients, and the treatment was divided into three stages according to the goal of voice therapy. The treatment stages consist of 1) skill acquisition, 2) habit formation, and 3) habit changes. voice therapy was performed by applying SR strategies such as goal implementation intentions and a less routine behavior. Patient's dropout rates were measured to compare the adherence of voice therapy. Results : Significant improvement was seen in all groups receiving voice therapy. However, in the group using the SR strategy, the voice analysis results showed a relatively low dropout rate of voice therapy. In the generalization confirmation stage, patients who applied SR concept showed better results. SR strategy did no longer be necessary to maintain newly adopted vocal behavior. Conclusion : The results of this study show that SR is one of the cognitive factors that can have a significant impact on the outcome of voice therapy, and also has a positive impact on the acquisition and generalization of new skills. A better understanding of SR and the development of therapeutic strategies using it will play an important role in solving voice problems in clinical settings.

Differentiation of Adductor-Type Spasmodic Dysphonia from Muscle Tension Dysphonia Using Spectrogram (스펙트로그램을 이용한 내전형 연축성 발성 장애와 근긴장성 발성 장애의 감별)

  • Noh, Seung Ho;Kim, So Yean;Cho, Jae Kyung;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.100-105
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    • 2017
  • Background and Objectives : Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Materials and Methods : From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Results : Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups. Conclusion : The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.

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