• 말소리와 음성과학
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• 제6권2호
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• pp.37-45
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• 2014

The purpose of this study was to determine whether the Korean Singing Voice Handicap Index (K-SVHI) was suitable for singers in other genres than vocal music to assess their vocal problems subjectively. Twenty six college students majoring in vocal music and twenty six students majoring in applied music were included in the study. They were divided into G0 and G1 in voice quality using the GRBAS scale during the tasks of singing. K-SVHI was divided into three sub-areas (Physical, Functional, and Emotional). In the singing task, both groups showed no significant difference between K-SVHI scores by G scale. In the reading task, the vocal music group had significantly higher K-SVHI in G0 than in G1 in K-SVHIs by G scale, while the applied vocal music group had significantly higher K-SVHI in G1 than in G0. Also, the two groups were not significantly different in G0, G1 in the singing task while the vocal music group showed higher K-SVHI than the applied vocal music group in G0 in the reading task. In addition, the vocal music group had higher K-SVHI than the applied vocal music group in G1 in both tasks. As comparing by groups in three sub-areas of K-SVHI, significant differences were found in the Emotional and Functional area. Those results showed that singers felt their voice problems differently by musical genres, which means that K-SVHI may not be a proper tool for evaluating voice handicap of singers in diverse voice music genres.

• 말소리와 음성과학
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• 제3권2호
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• pp.99-105
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• 2011

The treatment for patients with mutational dysphonia typically is useful with vegetative phonation, but has not yet been studied. This study attempts to identify the effect of $SKTCLP^{(R)}$ using throat clearing and laughing in patients with mutational dysphonia. The study, which was designed by the author, included 26 patients aged from 14 to 32 years (mean: 18.7 years) who had been diagnosed with mutational dysphonia between January 2007 and June 2010. Voice therapy for these patients included $SKTCLP^{(R)}$, ranging from two to seven sessions (mean: 3.8 sessions). Results were evaluated by videostroboscopy, perceptual evaluation of GRBAS scale, aerodynamic test, and acoustic analysis before and after therapy. Most patients could phonate with low pitch from the beginning and sustain with normal pitch sound in the last session. We had found that glottic gap reduced after therapy and anterior-posterior compression of superior laryngeal part at the first time, and these patients had complete closure of the glottis after treatment. The results of acoustic and aerodynamic measures after treatment indicated significant decreases in Fo, Jitter, Shimmer, SFF, and SPI, and increases in MPT, Psub, and vocal efficiency (p<.05). $SKTCLP^{(R)}$ may be a useful treatment method in managing mutational dysphonia. We can suggest this technique may be useful in improving the voice quality of other functional dysphonia having glottal chink or functional aphonia.

• 말소리와 음성과학
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• 제7권4호
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• pp.67-76
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• 2015

The purpose of this study was to compare professional (Pro) and non-professional (Non-pro) voice users with voice disorders in self-reporting voice evaluation using Korean-Voice Handicap Index (K-VHI) and Korean-Voice Related Quality of Life (K-VRQOL). In addition, those were compared by voice quality and voice disorder type. 94 Pro and 106 Non-pro were asked to fill out the K-VHI and K-VRQOL, perceptually evaluated on GRBAS scales, and divided into three types of voice disorders (functional, organic and neurologic) by an experienced speech-language pathologist and an otolaryngologist. The results showed that the functional (F) and physical (P) scores of K-VHI in Pro group were significantly higher than those in Non-pro group. As the voice quality evaluated by G scale got worse, the scores of all aspects except emotional (E) of K-VHI and social-emotional (SE) of K-VRQOL were higher. All scores of K-VHI and K-VRQOL in neurologic voice disorders were significantly higher than those in functional and organic voice disorders. In conclusion, professional voice users are more sensitive to their functional and physical handicap resulted by their voice problems and that goes double for the patients with severe and neurologic voice disorders.

• 말소리와 음성과학
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• 제5권4호
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• pp.33-41
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• 2013

This study investigated the perceptual and cepstral/spectral characteristics of phonation and their relationships in dysarthria in connected speech. Twenty-two participants were divided into two groups; the eleven dysarthric speakers were paired with matching age and gender healthy control participants. A perceptual evaluation was performed by three speech pathologists using the GRBAS scale to measure the cepstrual/spectral characteristics of phonation between the two groups' connected speech. Correlations showed dysarthric speakers scored significantly worse (with a higher rating) with severities in G (overall dysphonia grade), B (breathiness), and S (strain), while the smoothed prominence of the cepstral peak (CPPs) was significantly lower. The CPPs were significantly correlated with the perceptual ratings, including G, B, and S. The utility of CPPs is supported by its high relationship with perceptually rated dysphonia severity in dysarthric speakers. The receiver operating characteristic (ROC) analysis showed that the threshold of 5.08 dB for the CPPs achieved a good classification for dysarthria, with 63.6% sensitivity and the perfect specificity (100%). Those results indicate the CPPs reliably distinguished between healthy controls and dysarthric speakers. However, the CPP frequency (CPP F0) and low-high spectral ratio (L/H ratio) were not significantly different between the two groups.

• 대한후두음성언어의학회지
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• 제30권1호
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• pp.48-52
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• 2019

Background and Objectives : Functional aphonia is characterized by incomplete closure of the vocal folds. Semi-occluded vocal tract exercise (SOVTE) allows smoothly vocal folds collision without damage to the vocal folds tissues to produce normal vocal intensity. The purpose of this study is to report the effect of SOVTE in patients with functional aphonia. Materials and Method : Seven patients diagnosed with functional aphonia were treated with 1-3 voice therapy sessions using voiced lip-trill, humming, Lax Vox in SOVTE. To assess the effectiveness of semi-occluded vocal tract exercise, cepstral analysis and auditory perceptual assessment were performed before and after voice therapy. Results : F0 (fundamental frequency), CPP (cepstral peak prominence) and L/H ratio (low/high spectral ratio) were significantly increased, while CPP Standard deviation, L/H ratio Standard deviation were decreased. In addition, 'Grade', 'Breathiness' and 'Asthenia' were significantly decreased in the GRBAS scale after SOVTE (p<0.05). Conclusion : In our study, SOVTE seemed to be effective to elicit voice quickly and promote vocal folds vibration without muscular effort in patients with functional aphonia.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.118-123
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• 2019

Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.100-105
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• 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.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.39-45
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• 2000

Background and Objectives : Accent method is one of holistic approaches for behavior readjustment of voice therapy The aim of this study is to evaluate the efficacy of the accent method of voice therapy for the patients who have no improvement after LMS. Materials and Methods : Of the patients who had been undergone LMS during the period from Jan. 1999 to Dec. 1999, medical records of 38 patients who had not been improved were studied retrospectively. 19 patients(treatment group) were applied accent method and the other 19 patients(control group) refused voice therapy. The voice of all the patients of both group were analysed with CSL and Aerophone II programs in pre- and post operative period. The voice of treatment group were analysed with Visi-Pitch II program before the application of accent method and after the completion of accent method. Then, the results were compared using paired t-test. Results : The results of voice analysis were not different statistically between pre- and postoperative examination in both group. After application of accent method in the treatment group, fundamental frequency(F$_{0}$) of male, relative average pertubation, and shimmer were revealed significant differences(p＜0.01), and decrease in grade(G) scale and roughness(R) scale were statistically Important in perceptual analysis using GRBAS criteria(p＜0.01). But $F_0$ of female, maximal phonation time and S to Z ratio were not revealed significant differences. Conclusions : Accent method of voice therapy may be as a supplement- ary therapy in the patients who were not improved after surgery.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.134-137
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• 2007

Background and Objectives: The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. It is generally believed that the reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve laryngeal function. The objective of this study is to evaluate of voice function after VPL with mucosal flap and fat graft reconstruction. Materials and Methods: From 1994 to 2006, 13 patients, who had been treated with VPL with mucosal flap and fat graft reconstruction. The voice characteristics, acoustic, aerodynamic parameter were measured in 13 patients after vertical partial laryngectomy with mucosal flap and fat graft reconstruction. Acoustic analysis was carried out using Computerized Speech Lab (CSL) and aerodynamic analysis were carried out using Aerophon II,3 months and 12 months after surgery. Results: The GRBAS scale, jitter, shimmer, NHR were improved as time goes on after surgery. But, maximum phonation time was shortened after surgery and there is no significant differences between before and after surgery in mean flow rate. Conclusion: The voice function of the mucosal flap and fat graft reconstruction after VPL were satisfactory. This can be an excellent reconstruction method after vertical partial laryngectomy.

• 대한후두음성언어의학회지
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• 제31권1호
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• pp.13-18
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• 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.