• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.28 no.2
• /
• pp.100-105
• /
• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.2
• /
• pp.119-122
• /
• 2022

Functional aphonia is a disease in which normal vocal ability is suddenly lost. When voice therapy is started at an early stage, the prognosis is good. However, if the functional aphonia persists for a long time, there is a possibility that the voice disorder may become fixed, though reports of these characteristics are rare. The authors experienced a patient with functional aphonia that occurred in adolescence and lasted for 7 months and reported the result of treatment.

• Journal of Clinical Otolaryngology Head and Neck Surgery
• /
• v.29 no.2
• /
• pp.212-222
• /
• 2018

Background and Objectives : The purpose of this study was to compare the measured values of acoustic and auditory perceptual assessments between normal and functional dysphonia (FD) groups. Materials and Methods : 102 subjects with FD and 59 normal voice groups were participated in this study. Mid-vowel portion of the sustained vowel /a/ and two sentences of 'Sanchaek' were edited, concatenated, and analyzed by Praat script. And then auditory-perceptual (AP) rating was completed by three listeners. Results : The FD group showed higher acoustic voice quality index version 2.02 and version 3.01 (AVQIv2 and AVQIv3), slope, Hammarberg index (HAM), grade (G) and overall severity (OS), values than normal group. Additionally, smoothed cepstral peak prominence in Praat (PraatCPPS), tilt, low-to high spectral band energies (L/H ratio), long-term average spectrum (LTAS) in FD group were lower than normal voice group. And the correlation among measured values ranged from -0.250 to 0.960. In ROC curve analysis, cutoff values of AVQIv2, AVQIv3, PraatCPPS, slope, tilt, L/H ratio, HAM, and LTAS were 3.270, 2.013, 13.838, -22.286, -9.754, 369.043, 27.912, and 34.523, respectively, and the AUC of each analysis was over .890 in AVQIv2, AVQIv3, and PraatCPPS, over 0.731 in HAM, tilt, and slope, over 0.605 in LTAS and L/H ratio. Conclusions : In conclusion, AVQI and CPPS showed the highest predictive power for distinguishing between normal and FD groups. Acoustic analyses and AP rating as noninvasive examination can reinforce the screening capability of FD and help to establish efficient diagnosis and treatment process plan for FD.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.6 no.1
• /
• pp.16-21
• /
• 1995

Clinical study was performed on 128 cases who complained of hoarsseness in according to causes therapies. which causes were newly known and advanced treatment methods were developed. The following results were obtained : 1) Among 128 cases, male was 45.3%, and female 54.7%, so sex ratio was 1:1.2. 2) The highest incidence of age causing hoarseness in order of frequency were 4th decade 30.5%, 5th decade 26.6% and 6th decade 24.8%. 3)The underlying diseases causing hoarsensess in oder of frequency were functional dysphonia 26.5%, laryngeal nodule 17.7% and chroic laryngitis 16.3%. 4) In view of the occupation. sterss group was 84.1% and non-stress group 15.9%. 5) The highest incidence of associated diseases in order of frequency were gastro intestinal diseases 29.7%, hypertension 9.4% and pulmonary tuberculosis 2.3%. 6) Vocal hygiene and voice therapy are the most needful therapeutic modalities.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.32 no.2
• /
• pp.75-80
• /
• 2021

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly. Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared. Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved. Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient's vocalization and improving voice quality, pitch and loudness.

• Archives of Craniofacial Surgery
• /
• v.20 no.5
• /
• pp.314-318
• /
• 2019

Macroglossia is a rare clinical condition defined as an enlarged tongue. Macroglossia can cause structural deformities like diastema and disproportionate mandibular growth and present functional disorders such as dysarthria, dysphonia, and respiratory problems. A 7-year-old boy who had lymphangiomatous macroglossia was treated with a reduction glossectomy by anchor-shaped combination of a U-shape and modified key-hole resection. Postoperatively, the reduced tongue was contained completely within the oral cavity, but open bite remained due to prognathism. Sensory and motor nerves to the tongue appeared to be intact, and circulation was adequate. This patient will be monitored for recurrence of tongue enlargement.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1982.05a
• /
• pp.10.1-10
• /
• 1982

The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.11 no.2
• /
• pp.161-166
• /
• 2000

Background and Objectives : Vocal fold hemorrhage occur by blood accumulation in Reinke's space by vocal trauma. It is mostly asymptomatic, but in some cases it may cause severe dysphonia. It is often seen in patients who use their voice professionally. However, recent changes of life style affected the phonation in general population. We studied to know what are the causes and what are the major factors to affect the vocal fold hemorrhages. Materials and Methods : 19 subjects were evaluated by using of questionaire and laryngoscopic examinations. We evaluated the factors to lead the change in voice directly, underlying causes, occupations and laryngeal findings. Results : The direct causes of the vocal fold hemorrhages were clearing throat, talking, coughing and singing. Reflux laryngitis and upper respiratory infection were the underlying diseases. Vocal fold hemorrhages were developed during the menstruation in 5 patients. Accompanying functional voice disorders were seen in 13 patients, such as, vocal fold nodule, nodule with varix, vocal polyp, Reinke's edema. Patients with reflux laryngitis had the habits of clearing throat as the direct cause of the vocal fold hemorrhages and had hyperkinetic functional voice disorders. Voice abuse was the direct cause of the vocal fold hemorrhages in patients who was in the period of the menstruation. The most common site of the hemorrhage was at the membranous portion of the vocal folds. Conclusions : Authors thought the forceful laryngeal activity was the cause of the vocal fold hemorrhages. And reflux laryngitis and menstruation was the risk factors of the vocal fold hemorrhages.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.31 no.1
• /
• pp.13-18
• /
• 2020

Background and Objective The purpose of this study is to report the effect of voice therapy using the voice reinforcement method (VRM) in patients with vocal nodules. It is one of the holistic voice therapy methods for improving vocal mechanisms. VRM includes not only direct and indirect voice therapy, but also trial therapy and self-practice. Composed of four stages: vocal hygiene education, relaxation, reinforcement, and generalization. Materials and Methods The subjects were 13 patients who were diagnosed with vocal nodules. Acoustic analysis, auditory perceptual assessment, K-VHI-10 and nodules size were compared before and after voice therapy. Voice therapy was conducted by speech-language pathologist and the mean number was 4.2. Results In acoustic analysis, Jitter, vF₀, vAm, Shimmer, NHR, and VTI were significantly decreased. F₀ was increased after voice therapy for women. 'Grade', 'Rough,' and 'Breathy' were significantly decreased in the GRBAS scale after voice therapy. In addition, K-VHI-10 and nodules size were significantly decreased. Conclusion VRM seems to be an effective voice therapy method in vocal nodules treatment. In VRM, especially, trial therapy is given motivation for vocal nodules treatments and self-practice has a continuous therapeutic effect in everyday life. VRM can be also applied to the voice therapy for other hyper-functional dysphonia.