• 말소리와 음성과학
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• 제10권4호
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• pp.155-161
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• 2018

The purpose of this study was to evaluate the efficacy of a multiple voice therapy technique ($SKMVTT^{(R)}$) using laughter for the treatment of various benign vocal fold lesions. To achieve this, 23 female patients diagnosed with vocal nodules, vocal polyp, and muscle tension dysphonia through videostroboscopy were enrolled in vocal hygiene and $SKMVTT^{(R)}$. All of the patients were treated once a week for 4 to 12 sessions. The GRBAS scale was used to confirm the changes in voice quality before and after the treatment. Acoustic analysis was performed to evaluate jitter, shimmer, NHR, fundamental frequency variation, amplitude variation, PFR, and dB range. Videostroboscopy was performed to confirm the changes in the laryngeal features before and after the treatment. After the $SKMVTT^{(R)}$, the results of the perceptual evaluation demonstrated that the G, R, and B scales significantly improved. An acoustic evaluation also demonstrated that jitter, shimmer, NHR, vAm, vFo, PFR, and dB range also significantly improved after the $SKMVTT^{(R)}$. In comparison to the videostroboscopic findings, the size of the vocal nodules and vocal polyp decreased or disappeared after the treatment. In addition, the size of the cuneiform tubercles decreased, the length of the aryepiglottic folds became longer, and the laryngeal findings of the supraglottic compressions improved after the $SKMVTT^{(R)}$. These results suggest that the $SKMVTT^{(R)}$ is effective in improving the vocal quality of patients with benign vocal fold lesions. In conclusion, it seems that laughter and inspiratory phonation suppressed abnormal laryngeal elevation and lowered laryngeal height, which seems to have the effect of improving hyperfunctional phonation.

• 대한후두음성언어의학회지
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• 제29권2호
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• pp.83-86
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• 2018

Background and Objectives : This study aimed to evaluate efficacy and complication of injection laryngoplasty using calcium hydroxyapatite (CaHA) for unilateral vocal fold paralysis in Asian. Materials and Methods : A prospective study was conducted on the adult patients with unilateral vocal fold paralysis from May 2015 through January 2016. Injection laryngoplasty was performed by one laryngologist. All patients underwent prospective voice evaluation using the subjective and objective comprehensive battery of assessments, before the procedure and after the procedure at 3 months, and 6 months. Results : A total of 7 patients (5 males and 2 females) were included in this study. VHI-10 was significantly decreased after injection laryngoplasty, at postoperative 6 months (p=0.031), while VAS score and MDADI showed no difference. GRBAS scale gradually decreased in 3 months and 6 months follow-up without statistical significance. Acoustic analysis revealed that jitter, shimmer, and noise-to-harmonic ratio continuously decreased from the baseline at 3 months and 6 months, although statistical significance was not attained. In the aerodynamic analysis, maximal phonation time was gradually increased at 3months and 6 months with significant difference (p=0.016, 0.031, respectively). There was no side effect associated with the procedure. Conclusion : CaHA can be safely used in Asian patients and the onset of maximal efficacy seems to be slow than other studies with Caucasian patients.

• 말소리와 음성과학
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• 제13권4호
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• pp.67-74
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• 2021

본 연구는 영유아 교육시설에서 근무하는 음성의 불편감을 호소하는 10명의 여성 교사들을 대상으로 반폐쇄성도훈련(semi-occluded vocal tract exercise, SOVTE)을 원격으로 실시하였을 때 주관적으로 평가하는 음성평가에 미치는 효과를 살펴보았다. 원격 SOVTE의 효과는 한국어판 음성장애지수(Korean voice handicap index, KVHI), 음성 활동 및 참여 프로파일-한국판(Korean version of the voice activity and participation profile, K-VAPP), 음성노력도 및 GRBAS를 이용한 청지각적 평가로 평가하였다. 연구 결과, KVHI의 총 점수, 기능적 점수, 신체적 점수는 원격 SOVTE를 실시한 후에 통계적으로 유의하게 낮아졌다. 원격 SOVTE 실시 후 K-VAPP의 총 점수도 유의하게 감소하였으며, 음성노력도 또한 유의하게 감소하였다. 그러나 GRB 척도는 원격 SOVTE 실시 전과 후 간에 통계적으로 유의한 차이를 보이지 않았다. 본 연구를 통해 영유아 여성 교사에게 원격으로 실시한 SOVTE는 음성의 불편감을 감소시키는데 효과적임을 입증하였으며, 원격으로 실시한 음성치료가 효과가 있음을 보여준다.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.31-36
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• 2022

Background and Objectives Proton pump inhibitors (PPIs), mucolytics, and steroids were commonly recommended after phonomicrosurgery to prevent worsening of vocal fold (VF) scar formation and subglottal swelling. However, there is no consensus about whether laryngeal reflux and thick discharge are associated with the voice outcomes following phonomicrosurgery in benign VF lesions. The purpose of this study is to examine voice outcomes of use of PPIs, mucolytics,and steroids after phonomicrosurgery. Materials and Method This randomized controlled study is performed with patients undergoing laryngomicroscopic surgery for VF polyp and cyst. Participants were randomly assigned to 1) no medication, 2) PPIs, 3) PPIs+mucolytics, and 4) PPIs+mucolytics+steroids for 2 months postoperatively. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed pre- and post-operatively at 2 months. Parameters were compared among four groups. Results Among 85 patients, a total of 50 patients were included. The VHI-10, perceptual and acoustic parameters improved in all groups after surgery. However, there was no significant difference in those parameters among all groups. Conclusion PPIs, mucolytics, and steroids did not significantly influence voice outcomes after phonomicrosurgery in patients with benign VF lesions.

• 말소리와 음성과학
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• 제12권4호
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• pp.91-98
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• 2020

근긴장성 발성장애(cepstral peak prominence, MTD) 환자의 모음 발성과 문장읽기 과제를 켑스트럼 기반 변수를 이용하여 분석하였으며 음성장애 환자의 GRBAS청지각적 특성과 음향학적 특성의 상관관계를 살펴보고, 랜덤포레스트 머신러닝 분류 알고리듬을 이용한 MTD 감별 진단 가능성을 논의하였다. 내원 시 MTD로 진단받은 여성 36명과 정상음성을 사용하는 여성 36명이 연구에 참여했으며, 수집한 음성샘플은 ADSVTM를 사용하여 분석하였다. 연구 결과, 음향학적 측정치 중 MTD의 CSID(cepstral spectral index of dysphonia)는 대조군보다 높았으며, CPP(cepstral peak prominence), CPP_Fo 값이 대조군보다 유의하게 낮았다. 이는 모음 발성과 읽기 과제에서 모두 동일하게 나타났다. MTD 환자의 음질 특성은 전반적인 음성중증도(G)가 가장 두드러졌으며, 조조성(R), 기식성(B), 노력성(S)순으로 음성 특성을 보였다. 이 특성이 높아질수록 CPP가 감소하는 부적 상관을 보이고, CSID는 증가하는 정적 상관이 관찰되었다. 켑스트럴 변수 중 모음과 문장읽기과제 모두에서 집단간 유의한 차이를 보여준 CPP와 CPP_F0를 이용하여 MTD와 대조군의 음성분류를 시도하였다. 머신러닝 알고리듬인 랜덤포레스트로 모델링한 결과 문장읽기 과제에서 모음연장발성보다 조금 더 높은 분류 정확도(83.3%)가 나왔으며, 모음 발성과 문장 읽기 과제 모두에서 CPP변수가 더 중심적 역할을 수행하였음을 알 수 있었다.