• Title/Summary/Keyword: 발성장애

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Clinical Analysis of Spasmodic Dysphonia (연축성 발성장애의 임상적 고찰)

  • 최홍식;문형진;김상균;이준협;안성윤;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.8 no.1
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    • pp.54-58
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    • 1997
  • Spasmodic dysphonia is an uncommon and poorly understood disorder of motor control of laryngeal speech. We analysed 88 patients with spasmodic dysphonia, using chart review. These patients had historical information evaluated for age of onset(mean 39.2 years), duration of symptoms(mean 8.8 years), sex(4.2 : 1 female to male) family history(positive in 16.7%), and primary(84.8%) and secondary(15.2%) etiology : neurological evaluation for other dystonic involvement(40.7%). Eighty-three patients(94.3%) had adductor type of spasmodic dysphonia and 4 patients were abductor type and 1 patient was mixed type. All patients had normal thyroid and parathyroid functions and among 46cases, 8 patients had abnormal brain MRI finding. seventeen patients were evaluated by auditory brainstem response parameters. four out of the 17 patiemts had prolonged wave Ⅰ-Ⅴ interpeak latency.

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Treatment of a Case with Dysphonia Due to Large Posterior Glottal Chink Using Arytenoid Adduction and Type I Thyroplasty (피열연골내전술과 제1형 갑상성형술을 이용한 성문후부부전에 의한 발성장애의 치험 1례)

  • 최홍식;최재진;조정일;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.6 no.1
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    • pp.39-42
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    • 1995
  • Surgical treatment options of symptomatic unilateral vocal fold paralysis are Teflon injection, type Ⅰ thyroplasty, and arytenoid adduction. Arytenoid adduction is preferable to type Ⅰ thyroplasty for correcting the level different that may be present between two vocal folds and the large glottal chink However there is no known therapeutic modality effective to correct the large posterior glottal chink of the vocal fold with relatively normal mobility. Recently we have experienced a case of severe large posterior glottal chink of the vocal 1314s with relatively normal mobility after thyroid lobectomy, successfully treated with type Ⅰ thyroplasty combined with arytenoid adduction.

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The Effect of an Anticholinergic Agent(Oxybutynin) on Spontaneous Resolution of Primary Vesicoureteral Reflux (항콜린제(옥시부티닌)가 원발성 방광요관역류의 자연 소실에 미치는 영향)

  • Ahn So-Hyun;Shim So-Yun;Lee Jung-Won;Cho Su-Jin;Lee Seung-Joo
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.174-180
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    • 2003
  • Purpose : Unstable bladder has been known to be one of the reasons for the genesis and persistance of primary vesicoureteral reflux(VUR) in children. And treatment of unstable bladder by anticholinergic agent may contribute to the resolution of primary VUR. We evaluated the effect of an anticholinergic agent(oxybutynin) on the resolution of primary VUR in children with different toilet training and voiding functions. Methods : 152 children with persistant primary VUR after one year of follow up were randomly assigned to the oxybutynin group(n=59, oxybutynin 0.2 mg/kg twice daily) and the control group(n=93, no oxybutynin) at Ewha Womans University Mok-Dong Hospital from October 1996 to April 2002. The resolution rate of the VUR and the difference according to the status of toilet training and voiding dysfunction were analyzed. Statistical analysis was done by the Chi-square test and a P-value of less than 0.05 was considered as significant. Results : VUR was resolved in 49.2%, improved in 20.3% and not changed in 30.5% in the oxybutynin group(n=59) which was not significantly different to 45.2%, 16.1%, 38.7% in the control group(n=93), respectively. In the non-toilet trained young children, VUR was resolved in 50.0%, improved in 23.5% and not changed in 26.5% in the oxybutynin group(n=34) which was not significantly different to 44.2%, 19.2%, 36.6% in the control group(n=52), respectively. In the toilet trained older children, VUR was resolved in 48.0%, improved in 16.0% and not changed in 36.0% in the oxybutynin group(n=25) which was not significantly different to 46.3%, 12.2%, 41.5% in the control group(n=41), respectively. In the toilet trained older children with no voiding dysfunction, VUR was resolved in 33.3%, improved in 11.1% and not changed in 55.5% in the of oxybutynin group(n=9) which was not significantly different to 53.6 %, 10.7%, 35.7% in the control group(n=28), respectively. In the toilet trained older children with voiding dysfunction, VUR was resolved in 56.3%, improved in 18.7% and not changed in 25.0% in the oxybutynin group(n=16), which looked higher than 30.7%, 15.4%, 53.9% in the control group(n=13), respectively, but these were not significantly different either. Conclusion : Oxybutynin was not effective in the resolution of primary VUR in non-toilet trained young children and toilet trained older children. Oxybutynin showed slightly higher tendency of reflux resolution in toilet-trained older children with voiding dysfunction but the difference was not statistically significant. Judicious use of oxybutynin is required in selected older children with VUR and voiding dysfunction.

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Aerodynamic Study in Normal Korean and Patients with Vocal Polyp (정상인과 성대용종 환자에서의 공기역학적 검사)

  • 서장수;송시연;정유선;김정수;지덕환;이무경
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.1
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    • pp.5-11
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    • 1999
  • Background and Objectives : Recently, many people suffering from voice change visit otolaryngologist. So, it is important to study vocal function in patients with glottic or laryngeal disease. Aerodynamic investigation is valuable information about the efficiency of the larynx in translating air pressure to acoustic signal. The purpose of this study was to investigate the aerodynamic data in patients with vocal polyp, compare this data with that of the normal Korean. Materials and Methods : In aerodynamic study, maximum phonation time, mean air flow rate, phonatory flow volume and subglottal pressure were tested by using Aerophone II voice function analyzer in 157 normal korean and 143 patients with vocal polyp, aged from 20 to 69 years randomly selected. Results and Conclusion : In vocal polyp, maximum phonation time was significantly decreased and mean air How rate was increased. Phonatory flow volume was significantly decreased and subglottic pressure was increased only in female with vocal polyp. These data will be served as basic data of evaluation after treatment and postoperative assessment of the patients with vocal polyp.

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Botulinum Toxin Injection for Postlaryngectomy esophageal speech failure and Achalasia (보툴리눔독소를 이용한 후두전적출술후 식도발성장애 및 식도이완불능증의 치료)

  • 최홍식;문형진;한재욱;서진원;김광문
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.302-306
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    • 1997
  • Persistent pharygoesophageal spasm has been demonstrated to be responsible for poor speech rehabilitation after laryngectomy Management of these patients has included bougienage and pharyngeal neurectomy. Achalasia is a disorder of swallowing in which the lower esophageal sphincter fails to relax. Botulinum toxin injection of the upper esophageal sphincter or lower esophageal sphincter has been successfully used diagnostically and therapeutically for esophageal speech failure or achalasia. So, we report the use of botulinum toxin, a paralytic agent, for the treatment of these conditions.

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요전완유리피판을 이용한 연구개 결손부 재건후 기능평가

  • 박해섭;김민식;선동일;유우정;김형태;박영학;조승호
    • Proceedings of the KSLP Conference
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    • 1998.11a
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    • pp.188-188
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    • 1998
  • 구강후부암은 흔히 연구개, 설근부 등을 침범하여 연구개의 절제가 동반되고 이에 따른 발성, 연하 등에 장애를 남기게 된다. 이의 재건을 위해 다양한 피판술이 고안되고 있으며 그 중 요전완유리피판은 피판이 얇고 유연하여 입체적 형태의 재건이 용이하며 감각신경을 포함하여 재건할 수 있고 장장근인대를 포함시킬 경우 연구개의 역동적인 기능까지 재건할 수 있는 등의 장점으로 최근 많이 이용되고 있다. (중략)

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Robust Speech Recognition Algorithm of Voice Activated Powered Wheelchair for Severely Disabled Person (중증 장애우용 음성구동 휠체어를 위한 강인한 음성인식 알고리즘)

  • Suk, Soo-Young;Chung, Hyun-Yeol
    • The Journal of the Acoustical Society of Korea
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    • v.26 no.6
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    • pp.250-258
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    • 2007
  • Current speech recognition technology s achieved high performance with the development of hardware devices, however it is insufficient for some applications where high reliability is required, such as voice control of powered wheelchairs for disabled persons. For the system which aims to operate powered wheelchairs safely by voice in real environment, we need to consider that non-voice commands such as user s coughing, breathing, and spark-like mechanical noise should be rejected and the wheelchair system need to recognize the speech commands affected by disability, which contains specific pronunciation speed and frequency. In this paper, we propose non-voice rejection method to perform voice/non-voice classification using both YIN based fundamental frequency(F0) extraction and reliability in preprocessing. We adopted a multi-template dictionary and acoustic modeling based speaker adaptation to cope with the pronunciation variation of inarticulately uttered speech. From the recognition tests conducted with the data collected in real environment, proposed YIN based fundamental extraction showed recall-precision rate of 95.1% better than that of 62% by cepstrum based method. Recognition test by a new system applied with multi-template dictionary and MAP adaptation also showed much higher accuracy of 99.5% than that of 78.6% by baseline system.

The Perceptual Evaluation and Aerodynamic Analysis of Spasmodic Dysphonia (연축성발성장애의 청지각적 평가 및 공기역학적 특성)

  • Park, Sun-Young;Kim, Jae-Ock;Lim, Sung-Eun;Nam, Do-Hyun;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.38-42
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    • 2008
  • Background and Objectives : This study was performed to investigate the perceptual and aerodynamic characteristics and the relation between vocal efficiency and the severity of strained voice. of adductor spasmodic dysphonia. Materials and Methods : 13 female patients with adductor spasmodic dysphonia were examined and compared with 10 normal female control group. MPT, MFR, Psub, Sound Intensity, VE(vocal efficiency) were obtained using PAS(Phonatory Aerodynamic System). GRBA(S) scale was used for Perceptual evaluation. Results : Psub(subglottic pressure) of SD was significantly higher than normal group. MPT, MFR, Sound Intensity, VE were not significantly different between two groups. Correlation between VE and 'S'(strained) was not significant. Conclusion : The results of this study show that certain aerodynamic parameters(Psub) distinguish adductor spasmodic dysphonia from normal voice.

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Validity and Reliability of Korean Version of the Aging Voice Index (KAVI) (한국어판 노인음성지수의 신뢰도와 타당도)

  • Bae, In-Ho;Sung, Eui-Suk;Lee, Jin-Choon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.21-27
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    • 2019
  • Background and Objectives : Voice disorder is recognized as a major problem because it negatively affects the elderly's social participation and quality of life. The purpose of this study was to examine the validity and reliability of Korean aging voice index (KAVI), which assesses the quality of life related to the voice of the elderly. Materials and Method : This study was conducted on 211 elderly people aged 65 years or older : 111 patients with voice disorder (mean age 69.8, range 65-80 years) and 100 nomorphonic participants (mean age 70.6, range 65-82 years). Aging voice index was translated into Korean and used and Korean voice-related quality of life (KVQOL) was conducted to verify KAVI. The validity (item validity, concurrent validity, and construct validity) and reliability (test-retest reliability and internal consistency reliability) of KAVI. Results : The item validity (ICC=0.895) and construct validity (r=0.765) showed a high correlation, respectively. And concurrent validity (r=0.748), test-retest reliability (0.851), and internal consistency reliability (${\alpha}=0.832$) were statistically significant in voice disorder group. In addition, there was a significant difference between the voice disorder and the nomorphonic group in AVI total score. Conclusion : KAVI is a validated and reliable quality of life tool that will be useful for assessing the presence and effectiveness of interventions in clinical settings.

The Effect of Voice Therapy for Functional Voice Disorder (기능적 음성장애 환자에서의 음성치료의 효과)

  • 정성민;조윤희;홍순관;변성완;김은아;손지연;박애경
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.145-150
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    • 2002
  • Background and Objectives : Patients with so-called 'functional voice disorders' who have structurally normal larynges and demonstrate muscle misuse in the larynx, and those with several interacting causes including habitual muscle tension, are probably better defined as having a 'muscle misuse voice disorder'. The purpose of this study was to analyze the voice and effectiveness of voice therapy in patients with functional voice disorders and to provide a guide for the treatment of functional voice disorder. Materials and Method : The records of 35 patients, presenting with functional voice disorder and receiving voice therapy during October, 2001 to September, 2002, were reviewed. Prior to voice therapy, the stroboscopic examination of their larynx, aerodynamic and acoustic analysis was done. The results of voice therapy were compared according to the patient's subjective, perceptual evaluation of voice, and maximal phonation time. Results : Patient's subjective, perceptual evaluation, and maximal phonation time showed superior results after voice therapy. Conclusion : The result of this study indicates that voice therapy is an effective treatment method of patients with functional voice disorder, especially muscular tension dysphonia.

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