• 대한후두음성언어의학회지
• /
• 제26권2호
• /
• pp.122-126
• /
• 2015

Background and Objective : Laryngeal microscopic surgery (LMS) is popular method to treat for vocal polyp. There is not always the improvement of the voice after operation. Many methods have been developed for better outcome of the surgery. The purpose of this study is to investigate the effect of the triamcinolone injection at vocal cord during LMS. Materials and Methods : The medical records of 28 patients, received LMS under diagnosis of vocal polyp, were retrospectively reviewed. The patients were divided into two groups depending on whether triamcinolone injected or not (case group : Triamcinolone-injected group, control group : Triamcinolone-not injected group). The quality of voice was evaluated by GRBAS scale, fundamental frequency (Fo), jitter, shimmer and NHR (Noise to harmonic ratio) at previous operation, 4 weeks after operation, 8 weeks after operation. Each voice analysis factor was compared between case group and control group by Independent t-test. Results : The mean differences of each voice analysis factor. The mean difference of Jitter, Shimmer, NHR in case group were lower than in control group, and mean difference of GRBAS scale in case group were higher than in control group. These differences were not significant (p>0.05). Conclusion : Though there was a tendency of better voice outcome in patients of triamcinolone-injection, it may not be concluded that the triamcinolone injection is helpful for better voice outcome in surgery of vocal polyp due to statistical insignificance.

• 대한음성언어의학회:학술대회논문집
• /
• 대한음성언어의학회 1999년도 제12회 학술대회
• /
• pp.181-181
• /
• 1999

배경 : 음성평가에서는 기기를 이용한 객관적인 평가뿐만 아니라 청지각에 의한 주관적 평가가 매우 비중 있게 다루어져 왔다. 목적 : 본 연구에서는 객관적인 평가 중 음향학적 분석인 MDVP(Multidimensional Voice Program)의 지표들과 주관적 평가로 알려진 GRBAS점수를 비교하여 이들의 상관관계 정도를 성대결절을 대상으로 알아보고자 하였다. (중략)

• 대한후두음성언어의학회지
• /
• 제15권2호
• /
• pp.92-97
• /
• 2004

Background and Objectives : The purpose of this study was to examine objectively pre and post operative voice quality evaluation and intelligibility of alaryngeal voice using speech recognition program, HUVOIS. Materials and Methods : 2 laryngologists and 1 speech pathologist were evaluated 'G', 'R', 'B' in the GRBAS sclae and speech intelligibility using NTID rating scale from standard paragraph. And also acoustic estimates such as jitter, shimmer, HNR were obtained from Lx Speech Studio. Results : Speech recognition rate was not significantly different between pre and post operation for pathological vocie samples though voice quality(G, B) and acoustic values(Jitter, HNR) were significantly improved after post operation. In Alaryngeal voices, reed type electrolarynx 'Moksori' was the highest both speech intelligibility and speech recognition rate, whereas esophageal speech was the lowest. Coefficient correlation of speech intelligibility and speech recognition rate was found in alaryngeal voices, but not in pathological voices. Conclusion : Current study was not proved speech recognition program, HUVOIS during telephone program was not objective and efficient method for assisting subjective GRBAS scale.

• 한국산학기술학회논문지
• /
• 제13권3호
• /
• pp.1161-1169
• /
• 2012

본 연구의 목적은 DSI의 성별에 다른 유용성을 살펴보고자 하였다. 본 연구는 GRBAS에서 모두 0점을 받은 경기도 및 서울에 거주하는정상 한국인 30명(남자 15명, 여자 15명)을 대상으로 2011년 3월부터 6월까지 실험하였다. DSI를 구성하고 있는 파라미터인 최대 발성시간, 최대 기본주파수, 최저 강도, Jitter(%)는 CSL 4500(Kay Pentax. USA)을 이용하여 측정하였다. 검사자는 모든 피험자에게 실험조건과 절차에 대해서 설명해 주었으며, 본 실험에 앞서 시범을 보여주었다. 성(性)이 DSI에 미치는 영향을 살펴보기 위해서 Mann-Whitney 검정을 실시하였다. 본 실험 결과, 여성이 남성에 비해 최대 기본주파수는 높았지만 남녀간 DSI는 통계적으로 유의한 차이가 없었다. 따라서 DSI는 음성장애의 심한정도를 살펴볼 수 있는 객관적인 측정도구로 유용하다고 생각한다.

• 대한후두음성언어의학회지
• /
• 제24권2호
• /
• pp.112-117
• /
• 2013

Background and Objectives : This study aimed to determine the clinical effect of $Artecoll^{(R)}$ injection laryngoplasty for patients with vocal atrophy and mild sulcus vocalis. Materials and Method : Forty-one patients with vocal atrophy and/or mild sulcus vocalis received transcutaneous $Artecoll^{(R)}$ injection into the vocal folds under local anesthesia. Subjective evaluations including voice handicap index (VHI) and perceptual grading with Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scales and objective evaluations including jitter, shimmer, noise-to-harmonic ratio (NHR), speaking fundamental frequency (SFF) and maximum phonation time (MPT) were evaluated before and 3 months after the injection. Results : VHI and Grade, Breathiness and Strain scales in GRBAS showed significant improvement 3 months after injection. SFF and MPT also significantly improved after the injection ; MPT increased and SFF in male patients decreased. Conclusion : Injection laryngoplasty with $Artecoll^{(R)}$ is an effective method for correcting the glottal insufficiency and improving voice quality in patients with vocal atrophy and/or mild sulcus.

• 대한후두음성언어의학회지
• /
• 제20권1호
• /
• pp.52-56
• /
• 2009

Background and Objectives : Vocal nodule is common inflammatory vocal cord lesion which could be improved by voice rest or voice therapy. But some patients, who do not have any improvement after voice therapy, should take laryngomicorsurgery or additional long-term voice therapy. So we try to find prognostic factors which affect the results of voice therapy. Materials and Methods: There are 36 patients (response group) whose symptoms improved after initial voice therapy and 16 patients (no response group) whose symptoms did not improve at all. We compared clinical features (durations of symptoms, voice abuse, laryngopharyngeal reflux), GRBAS scale, acoustic analysis, aerodynamic analysis and voice handicap index between the two groups from January, 2006 to June, 2008. Results: Response group underwent voice therapy 4.5 times (ave.) and no response group underwent 6.7 times (ave.). No response group has longer duration of symptoms, higher GRBAS scale score, higher NIH ratio, and higher MFR than those of response group. Conclusion : This study found that the prognosis of voice therapy in patients who have longer duration of symptoms, high NIH ratio, and bad perceptional test result is not likely to be good. In those cases, we should recommend earlier surgery, voice therapy after surgery, and inform about the necessity of long-term voice rehabilitation or voice therapy in order to get favorable compliance.

• 대한후두음성언어의학회지
• /
• 제16권2호
• /
• pp.129-134
• /
• 2005

Background and Objectives : Artecoll(R) is an injectable soft tissue filler, which is a suspension of polymethylmethacrylate microspheres in $3.5\%$ bovine collagen solution. The authors aimed to determine the clinical of Artecoll of Artecoll(R) as an injection material into the vocal fold to correct the glottal insufficiency caused by unilateral vocal cord paralysis. Materials and Methods : Forty-one consecutive patients with unilateral vocal cord paralysis received percutaneous Artecoll injections under local anesthesia. Acoustic, aerodynamic and stroboscopic analyses were prospectively provided before, 1 week and 3 months after injection. Perceptual GRBAS grading by speech language pathologists and subjective ratings of the hoarseness and aspiration by the patients were also obtained. Results : Aerodynamic parameter(maximal phonation time) were significantly improved after the injection (p<0.05). Acoustic parameters (jitter and shimmer) were improved at the 3rd month follow-up. GRBAS uading and patients own subjective scaling of hoarseness and aspiration also showed significant improvement (p<0.05). Early or delayed significant side effects were not observed. Conclusion : Vocal fold injection with Artecoll is a convenient, safe and useful method of temporarily correcting the glottal insufficiency. Further long-term follow-up studies will answer the usefulness and safety of the Artecoll injection laryngoplasty.

• 음성과학
• /
• 제10권4호
• /
• pp.201-219
• /
• 2003

Background: The perceptual assessment is generally performed by the voice specialist. The objective evaluation is performed in a voice laboratory. Research in voice laboratories has generated a variety of different objective tests and parameters. The perceptual evaluation is one of the most controversial topics in voice research. Review of literature reveals a wide variety of rating scales and reliability data fluctuating from study to study. Unfortunately, there is no widely accepted valid method for classifying voice disorders and assessing outcome after voice treatment. Objectives: The goals of this research were to identify important objective acoustic parameters of vocal quality, and to establish an objective and quantitative correlate of the perceived vocal quality. Materials and Methods : We evaluated the voice analyzed data from 122 dysphonic patients and 20 normal volunteers. A computerized speech lab. 4300B(CSL) was used to carry out the analysis of each voice sample. Results: Three dysphonia severity indices(DSI) were created using discriminant analysis. DSI is based on the weighted combination of the following selected set of acoustic parameters: absolute jitter(Jita in us), smoothed pitch period perturbation (sPPQ in %), amplitude perturbation quotient(APQ in %), soft phonation index(SPI), average fundamental frequency(Fo in Hz), lowest fundamental frequency(Flo in Hz), and smoothed amplitude perturbation quotient(sAPQ in %). The DSI, being the discriminating rule calculated by the logistic regression, consists of three equation based on statistically significant acoustic parameters. Three DSI were created to reflects best the degree of hoarseness as expressed by G from the GRBAS scale. The more positive this DSI is for a patient, the worse the vocal quality. The more it is negative, the better it is. The effect of sex is included implicitly in the DSI-1 and DSI-2, so that a separate DSI-1 and DSI-2 for males and females need not be used. The DSI is objective because no perceptual input is required for its calculation. Conculsion : This research demonstrates that the voice function values calculated from three different multivariate objective dysphonia severity indices are significantly associated with subjective voice assessments. These multivariate objective dysphonia severity indices may be appropriate for use in clinical trials and outcomes research on treatment effectiveness for voice disorders.

• 대한후두음성언어의학회지
• /
• 제14권2호
• /
• pp.104-109
• /
• 2003

The purpose of this study is to analyze the EGG measures from Lx Speech Studio program (Laryngograph Ltd, UK) in patient with vocal nodule. Thirty female adults (15 patient with vocal nodule, 15 normal speaker) produced sustained vowel and read the passage. They were grouped into three groups based on Grade (GRBAS) : normal-G0, nodule-Gl, nodule-G2. Estimates of Fx (Hz), Qx(%), Jitter, Shimmer, and HNR were made from a 500msec midportion of vowel. In addition, DFx(Hz), DQx(%), CFx(%) and CAx(%) were obtained from reading the passage. These data were compared among groups. The results were as follow Jitter, Shimmer, HNR were significantly higher in nodule-G2 group than in normal-G0 & patient-Gl group. In nodule-G2 group, CFx and CAx from reading passage were significantly higher. For patients with nodule, asymmetry or irregularity were observed in graphs of QxFx ＆ CFx provided by Quantitative Analysis.

• 말소리와 음성과학
• /
• 제8권4호
• /
• pp.123-129
• /
• 2016

This study investigates the relationship between dysphonia severity index(DSI) and voice handicap index(VHI). Seventeen patients with a vocal nodule and twenty patients with laryngopharyngeal reflux(LPR) patients participated in this study. Results showed that there is no significant difference in either DSI or VHI between vocal nodule and LPR patients, with a weak negative correlation between DSI and VHI. Results also showed that there is significant difference only in both MPT and Fhi of all DSI parameters between vocal nodule and LPR patients. These results suggest that voice evaluation should be conducted both objectively in terms of acoustical and aerodynamic parameters and subjectively in terms of GRBAS and VHI.