• Title/Summary/Keyword: 발성 장애

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Diplophonia in Mutational Falsetto : Acoustic Characteristics and Treatment -A Case Report- (이중음성을 보인 변성발성장애 환자 음성의 음향학적 특성 및 치험례 -증 례 보 고-)

  • Lee, Jae-Yol;Lee, Sung-Eun;Lee, Sung-Eun;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.15 no.1
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    • pp.47-51
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    • 2004
  • Normally, as a result of increased laryngeal growth, the male voice drops about one octave in pitch level during adolescence. Failure of the voice to drop in pitch is consider to be a clinically significant voice disorder - 'mutational dysphonia'. The aim of this article is to evaluate the changes brought about by voice therapy, using the analysis of the EGG measure from Lx Speech Studio program(Laryngograph Ltd, UK) as well as acoustic, and aerodynamic studies in 18-year-old mutational dysphonia patient. The results from the Lx Speech Studio program demonstrated bimodal distribution of DFx(Hz), DQx(%), QxFx and diplophonic characteristic. After voice therapy combined with manual compression method, the distribution of DFx, DQx, QxFx was changed uniform with a dramatic reduction of higher pitch level. In addition, this finding suggests the EGG measure helps to choice treatment options, monitor the efficacy of therapy, and estimate the prognosis of diseases.

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Effects of Lax Vox voice therapy in a patient with spasmodic dysphonia: A case report (연축성 발성장애 환자의 Lax Vox 음성치료 효과)

  • Lim, Hye Jin;Choi, Seong Hee;Kim, Jeong Kyu;Choi, Chul-Hee
    • Phonetics and Speech Sciences
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    • v.8 no.2
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    • pp.57-63
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    • 2016
  • Recently, the Lax Vox voice therapy has been used as one of the SOVTE(Semi-Occluded Vocal Tracts Exercise). The purpose of this study was to explore the effect of Lax Vox voice therapy for a patient with Spasmodic dysphonia on voice improvement. One female spasmodic dysphonia patient(age=27) who had been diagnosed by a laryngologist received Lax Vox voice therapy. The Lax Vox protocol was configured as 5 steps (1 warm-up and 4 steps : bubbling without / with phonation/ gliding with phonation/ generalization) in this study. A total of 11 sessions were performed by a certified speech language pathologist. The present study evaluated the acoustic, aerodynamic, auditory perceptual, and patient's self-rating between pre-, mid-, and post- voice therapy. All objective and subjective parameters were improved after voice therapy; Reduced frequency variation, increased maximum phonation time, enlarged voice range, improved 'G' and 'S' in GRBAS & USDRS, and reduced VHI were observed. Especially, decreased $f_0$ and remarkably reduced voice tremor were also demonstrated following Lax Vox voice therapy. Accordingly, Lax Vox voice therapy technique can be useful for improving voice and quality of life in patients with spasmodic dysphonia.

Cepstral and spectral analysis of voices with adductor spasmodic dysphonia (내전형연축성 발성장애 음성에 대한 켑스트럼과 스펙트럼 분석)

  • Shim, Hee Jeong;Jung, Hun;Lee, Sue Ann;Choi, Byung Heun;Heo, Jeong Hwa;Ko, Do-Heung
    • Phonetics and Speech Sciences
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    • v.8 no.2
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    • pp.73-80
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    • 2016
  • The purpose of this study was to analyze perceptual and spectral/cepstral measurements in patients with adductor spasmodic dysphonia(ADSD). Sixty participants with gender and age matched individuals(30 ADSD and 30 controls) were recorded in reading a sentence and sustained the vowel /a/. Acoustic data were analyzed acoustically by measuring CPP, L/H ratio, mean CPP F0 and CSID, and auditory-perceptual ratings were measured using GRBAS. The main results can be summarized as below: (a) the CSID for the connected speech was significantly higher than for the sustained vowel (b) the G, R and S for the connected speech were significantly higher than for the sustained vowel (c) Spectral/cepstral parameters were significantly correlated with the perceptual parameters, and (d) the ROC analysis showed that the threshold of 13.491 for the CSID achieved a good classification for ADSD, with 86.7% sensitivity and 96.7% specificity. Spectral and cepstral analysis for the connected speech is especially meaningful on cases where perceptual analysis and clinical evaluation alone are insufficient.

The Phonatory Characteristics of Voice in Profoundly Hearing-Impaired Children: with Reference to F0, Intensity, and their Perturbations (심도 청각장애 아동의 발성특성: 강도, 음도 및 그 변동률을 중심으로)

  • Choi, Eun-Ah;Park, Han-Sang;Seong, Cheol-Jae
    • Phonetics and Speech Sciences
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    • v.2 no.1
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    • pp.135-145
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    • 2010
  • This study investigates the differences in mean F0, intensity, jitter, and shimmer across hearing aid, gender, and vowels. For this study, 18 hearing-impaired children, 18 cochlear implanted children, and 18 normal hearing children as a control group were asked to read seven Korean vowels (/$\alpha$, $\wedge$, o, u, w, i, $\varepsilon$/). Subjects' readings were recorded by NasalView and analyzed by Praat. Results showed that the means of F0 were significantly higher in the hearing impaired group than in the normal hearing group; in the female group than in the male group; and in high vowels than in low vowels. Second, intensity was significantly higher in the hearing impaired group than in the normal hearing group; in the female group than in the male group; and in low vowels than in high vowels. Third, jitter was significantly higher in the normal hearing group than in the hearing impaired group; in the female group than in the male group; and in back vowels than in front vowels. Finally, shimmer was significantly higher in the CI group than in the normal hearing group or the hearing aided group; in the male group than in the female group; and in low vowels than in high vowels.

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Comparison of the Surgical Results in Mutational Dysphonia between Unilateral Shortening of Thyroid Cartilage Method and Bilateral Shortening of Thyroid Cartilage Method in Type III Thyroplasty (변성발성장애의 제3형 갑상연골성형술시 갑상연골익의 편측절제술과 양측절제술과의 치료성적 비교)

  • 최홍식;김세헌;김영호;이익호;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.7 no.1
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    • pp.61-68
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    • 1996
  • Failure to change from the higher pitched voice of preadolescence to the lower pitched voice of adolescence and adulthood is called "mutational dysphonia" The voice is weak, thin, breathy, hoarse, and mono-pitched. If the voice theraphy was failed, surgery to lower vocal pitch which is refered to thyroplasty type III, is indicated. We compared the post-op acoustic parameters with pre-op data in unilateral antero-posterior shortening of the thyroid cartilage method and bilateral antero-posterior shortening of the thyroid cartilage method each other. Bilateral antero-posterior shortening of the thyroid cartilage method shows significant drop of fundamental frequency and speaking fundamental frequency statistically than unilateral shortening method. There was no significant differences in Jitter, Shimmer, SNR, MFR and other psychoacoustic analysiss parameters between two groups. These data shows that unequal tension of the vocal cord in uilateral antero-posterior shortening of the thyroid cartilage method does not control the pitch effectively so bilatreal shortening method in Type III thyroplasty is recommandable procedure in surgery of the mutational dysphonia.

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The Aerodynamic & Respiratory Muscle Pressure Aspects of Patients with Adductor Spasmodic Dysphonia (내전형 경련성발성장애의 호흡압력과 공기역학적 특징)

  • Nam, Do-Hyun;Choi, Seong-Hee;Choi, Jae-Nam;Choi, Hong-Shik
    • Speech Sciences
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    • v.12 no.4
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    • pp.203-213
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    • 2005
  • This study was conducted to investigate the respiratory and aerodynamic function of adductor spasmodic dysphonia (ADSD) patients. Participants were (1) 18 females SD patients with non- Botulinum toxin injection (2) 14 females SD patients who had taken treatment of Botulinum toxin injection. (3) 14 age- and sex- matched normal female controls. Spirometer and phonatory function analyzer were used for respiratory muscle pressure (MIP: Maximum inspiratory pressure), MEP: Maximum expiratory pressure)& MPT(Maximum phonation time) and aerodynamic(F0:Fundamental frequency, intensity, MFR: Mean flow late, Psub: Subglottal pressure) measurement. The results were as follows: (1) Normal group was significantly higher in MIP, MEP, MPT than two SD groups (p < .05); (2) MPT was significantly lower in SD with non-Botulinum toxin injection group than SD with the treatment experience of Botulinum toxin injection (p < .05); (3) All aerodynamic parameters, F0, intensity, MFR, Psub, were not significantly different among three groups(p > .05).The reason of short MPT in ADSD may use lower respiratory pressure than normal group as strategy to decrease their tremulous voice quality. Moreover respiratory muscle pressure was lower than normal group regardless of botulinum toxin injection treatment.

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Characteristics of Connected Speech in ADSD (내전형 연축성 발성장애의 연속 발화 특성)

  • Hwang, Yon-Shin;Kim, Jae-Ok;Choi, Hong-Shik
    • Phonetics and Speech Sciences
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    • v.1 no.1
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    • pp.93-98
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    • 2009
  • The aim of this study was to investigate voice characteristics of adductive spasmodic dysphonia(ADSD) by measuring electroglottal and acoustic examination at the sentence level. The clinical records of 86 ADSD female patients (age group of $20{\sim}50$ years) and the control records of 86 normal females (age group of $20{\sim}40$ years) were recorded by speech studio(Laryngograph Ltd., UK). An independent t-test was used to compare ADSD and normal group. Results were as follows. (1) Fundamental frequency($F_0$) was significantly decreased in ADSD compared with normal group. (2) Irregularity of frequency and closed quotient(CQ) was significantly increased in ADSD compared with normal group. (3) Voiceless duration increased and voiced duration was significantly decreased in ADSD compared with normal group. (4) Fricative duration was increased in ADSD compared with normal group but it wasn't significant. In conclusion, strained, tight and choked voice shows an increase of CQ, tremor voice shows an increase of irregularity of frequency and less feminine voice shows decrease of $F_0$. Increase of voiceless duration and fricative duration and decrease of voiced duration related with diminution speech intelligibility.

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A RESULT OF VOICE PRESERVATION FOLLOWING TREATMENT OF LARYNGEAL CANCER (후두암 치료후 음성보존의 성적)

  • 김형태;김형주;김민식;조승호;서병도
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.29-29
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    • 1991
  • 후두암의 치료는 병변의 위치, 크기 등에 따라 치료방법이 다양하고 그 예후 또한 상이하다. 일반적으로 초기 후두암에서는 수술이나 방사선 요법이 비슷한 치료결과를 보이고, 진행된 후두암에서는 수술적 치료가 더 좋은 예후를 나타내는 것으로 알려져 있으나 발성장애를 초래하는 경우가 대부분이다. 저자들은 1986년부터 1990년까지 5년간 강남성모병원에서 후두암치료를 받았던 환자 81명을 대상으로 치료방법에 따른 음성보존 성적을 분석하였다. 1. T1 성대암 환자 18명중 16명 (88.9%)에서 방사선치료 또는 수술로써 음성을 보존할 수 있었다. 2. T2 후두암 환자 11명중 6명은 수술후 음성보존이 가능하였다. 3. 진행암환자 (T3, T4) 50명중 33명에 대해 수술을 시행하였고 이중 16명(48.5%)은 후두부분 또는 근전적출술 및 기관-식도 누공술에 의해 음성기능을 보존할 수 있었다. 4. 진행암환자에서 유도화학요법과 방사선치료의 병용요법만을 받은 17명 모두 6개월 이내에 재발하였고, 수술 혹은 수술과 방사선 치료를 병용한 33명중 27명이 최소한 6개월 이상 평균 2년 이상의 무병상태였다. 5. 후두부분 또는 근전적출술은 총 81명중 28명에서 시행되었고 그중 5명 (17.9%)에서 재발하였다.

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A Case of the Laryngeal Papilloma Observed for the Past 13 Years (13년간 경과를 관찰한 후두유두종의 1예)

  • 이양선;박윤이;이인환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.5.2-5
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    • 1983
  • It is well known that laryngeal papilloma is histopathological benign, but clinically one of the most troublesome disease in otolaryngologic department, usually seen in child age. Since Cleesmann reported papilloma of the vocal cord, 1817 first, the etiology had not been known exactly. The symptoms in children are dyspnea, dysphonia due to recurrence, and papilloma in adult can change into neoplasm. The papilloma is thought as real neoplastic lesion and there is not effective treatment, using now repeated removal and combined therapy. This report is based on the typical findings and progress of one case of laryngeal papilloma observed for the past 13 years with repeated removal and topical application of 5-FU at our department. Authors have experienced this subject is interesting that the change of the tumor region during the course than to any new therapeutic methods employed, and so report with some reviews of the literatures.

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A Clinical Study on the 9 Cases of Laryngeal Granuloma Following Endotracheal Intubation (기관내 삽관후에 발생한 후두육아종 9례에 대한 임상적 관찰)

  • 이양선;이상흔
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.87.2-87
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    • 1976
  • Laryngeal granuloma following endotracheal anesthesia was reported as traumatic granuloma of the larynx by Clausen in 1932. Thereafter Harrison reported that 4% of the intubated cases developed larynx and upper respiratory tract injuries and 1% of the above mentioned injured cases later developed laryngeal granuloma with symptoms including voice change and even dyspnea in severe cases. The endotracheal intubation has been wedely used for general anesthesia or patency of the air way .and the reported cases of the laryngal granuloma Fig. 5. as its complication have been increased in number worldwidely. For a year from March 1975 to Feb. 1976, the authors have experienced the nine cases of laryngeal granuloma in our department and this is the report of clinical findings on these cases along with literature review.

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