• Title/Summary/Keyword: 발성 장애

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Controversies in Management of Functional Dysphonia (기능성 음성 장애 치료의 고려사항)

  • Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.86-89
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    • 2014
  • Functional dysphonia (FD) is a voice disorder in the absence of structural or neurologic laryngeal pathology. FD is not a single disease but a disease entity. Therefore several voice disorders, which have completely different pathogenesis, are included in this category. The first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. Several different treatment modalities are included in the managements of FD. Voice therapy is in charge of the main role in treatment of FD. Medical treatment is also necessary when patient has general problems which would affect voice production. Vocal folds mucosal lesions can cause FD even the lesion is minor. In this case proper surgical intervention helps to improve the symptom of FD. Psychiatric consultation should be considered when the patient has psychological problems.

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Glottic and subglottic airway obtruction

  • 김영모
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.113-113
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    • 2003
  • 성문과 성문하부의 기도 폐쇄는 위치 정도 원인 기간 등은 환자에 따라 다르고 그 치료방법 역시 다양하다. 주 원인으로는 기관내 삽관, 각종 외상 및 화상 등 을 들 수 있다. 이러한 질환의 치료 목적은, 기관내 튜브나 기관 캐뉼러 를 통하지 않고 비강을 통하여 자연스럽게 호흡할 수 있도록 기도를 유지 하면서 발성이 가능하고 기고 흡인 없이 연하가 가능하도록 하며 기침 반사가 원활하게 되도록 하는데 있다. 치료목적의 달성을 위하여 협착의 경우, 단계 즉 초기 단계 또는 성숙단계 여부, 위치, 정도, 범위 환자의 연령 전신상태 등을 술전에 잘 평가하고 수술도중의 소견과 술자의 경험이나 기호에 따라 적절한 치료법을 선택하여 치료해야 한다. 후두 외상에 의한 기도 문제는 다른 외상에 비해 흔하지 않은데 이는 연골의 유연성과 후두의 가동성 그리고 후두가 하악과 흉골사이에 위치하여 외상시 보호받게 되는 해부학적 특성에 기인한다. 여러 요인으로 인하여 진단이 늦어질 수도 있는데 이러한 경우 심각한 증상이 초래 되거나 치료가 의 시기가 지나 후두 또는 기관 협착, 발성장애등의 후유증이 유발 될 수 있다.

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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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Development of Differential Diagnosis Scale Items for Adductor Spasmodic Dysphonia and Evaluation of Clinical Availability (내전형 연축성 발성장애 감별진단 문항 개발과 임상적 유용성 평가)

  • Cho, Jae Kyung;Choi, Seong Hee;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.112-117
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    • 2019
  • Background and Objectives The purpose of this study was to develop the differential diagnosis scale containing items from adductor spasmodic dysphonia (ADSD) to muscle tension dysphonia (MTD) and the determine clinical utility of newly developed items. Materials and Method The four parts of pitch, redirected phonation, automatic speech and voiced sound were selected for analyzing the characteristics of ADSD in the literature. One part of tense voiceless sound was developed according to the Korean manner of articulation. The content validity was evaluated based on 5 scales (1-5 point) analysis from 30 experts. One hundred patients (50 ADSD and 50 MTD) were recorded in reading a sentence and sustained phonation. The two speech language pathologist evaluated recorded voices through a blind test using 4 scales (0-3 point) for newly developed items. Results As a result of verifying the content validity of items with experts, it was identified that the differentiated items were valid with 4.2 out of 5. Through the differential diagnosis between two groups according to the items, the correlation between sub-domains and total scores was shown as higher than 0.710. The result of analyzing the reliability on each diagnosis domain was 0.840-0.893, which showed the internal consistency of items was great. Newly developed five parts of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). The reliability among the evaluators was analyzed as high with 0.892. Conclusion In this study, the differential diagnosis scale of ADSD was revealed as having validity and reliability. It is considered that it will be useful for differentiating ADSD and MTD in the clinical field.

Management of Anterior Glottic web with Laser Vaporization and Silastic Keel Insertion (성대전연부 격막의 레이저치료 및 endolaryngeal silastic keel 삽입술의 효과)

  • 최종욱;정도광;김용환;오재훈;허경회
    • Proceedings of the KSLP Conference
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    • 1993.12a
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    • pp.21-21
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    • 1993
  • 발성장애와 호흡곤란을 주소로 하는 성대 전연부 격막은 후두병변의 부적절한 치료, 만성염증 또는 외상 등의 후천적인 원인으로 발생하는 경우가 많다. 성문중 가장 협소한 부위인 전연부에 발생한 격막에 대하여는 여러 가지 다양한 치료방법이 보고되고 있지만, 재협착의 가능성이 높고, 치료후 반흔 조직에 의하여 음성의 질을 높이는데 한계점이 있다. (중략)

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Thyroplasty type III for high pitched voice (제 3 형 갑상연골성형술에 의한 병적인 고음성치료)

  • 홍기환;전동석;김영중
    • Proceedings of the KSLP Conference
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    • 1993.12a
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    • pp.22-22
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    • 1993
  • 병적인 고음성은 임상적으로 흔하지는 않지만 종종 볼 수 있는 질환으로서 치료에 대한 많은 논란이 있는 게 사실이다. 대개 음성교육에 의한 치료가 많이 시행되며 수술적인 치료로서는 제 3형 갑상연골성형술이 인정되어 온 것이 사실이다. 이러한 수술에 대한 적응증으로는 첫째 남자에서 오랫동안 너무 높은 음성(mutational voice disorder)을 가진 환자와 둘째 여러 가지 원인에 의해 성대가 너무 경직되어 고음이면서 애성(breathy voice)을 동반한 발성장애가 있겠다. (중략)

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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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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.