• 재활복지
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• v.22 no.1
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• pp.157-168
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• 2018

The purpose of this study is to investigate the impact of semi-closed vocal training-based Vocal Aerobic Treatment on the voice improvement of soprano. Study subject was one soprano who appealed to the suffering of her voice problem due to vocal cord nodule. A study method of conducting pre/post acoustic evaluation and subjective voice evaluation to compare the measures was used; Vocal Aerobic Treatment was carried out twice a week for a total of 32 session. In the acoustic evaluation, MDVP (multi-dimensional voice program) and VRP (voice range profile) were used to evaluate the pitch, voice quality, and voice range; in the subjective voice evaluation, SVHI (singing voice handicap index) was used to assess voice satisfaction. As a result of the pitch evaluation, the soprano maintained a proper Fo. As a result of the voice quality evaluation, the jitter, shimmer, and the noise harmonic ratio numbers decreased compared to the numbers shown before the treatment. As a result of the voice range evaluation, the scope of the range was broadened, with the number of semitone increasing from 30 to 35. As for the subjective voice evaluation, the result of the total score obtained after the survey report divided by the number of questions showed a decrease from 3.6 to 0.6. The soprano herself reported of having a minor extent of a voice problem. The summary of the above results reflects that Vocal Aerobic Treatment is useful in the voice improvement of vocalists However, as this study is case research regarding the Vocal Aerobic Treatment effect on one soprano, further research on the treatment effect covering many other vocalists is necessary. Also, there is a need for follow-up studies regarding voice management and voice treatment program on not only the vocalists but also the voice users in many other professions.

• Journal of the Korean Society of Propulsion Engineers
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• v.4 no.4
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• pp.18-25
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• 2000

A two-color particle image velocimetry (PIV) has been developed for measuring two dimensional velocity flowfields and applied to a Mach 2.0 supersonic nozzle. This technique is similar to a single-color PIV technique except that two different color laser beams are used to solve the directional ambiguity problem. A green-color laser sheet (532 nm: 2nd harmonic beam of YAG laser) and a red-color laser sheet (619 nm: output beam from YAG pumped Dye laser using Rhodamine 640) are employed to illuminate the seeded particles. A high resolution (3060${\times}$2036) digital color CCD camera is used to record the particle positions. This system eliminates the photographic-film processing time and subsequent digitization time as well as the complexities associated with conventional image shifting techniques for solving directional ambiguity problem. The two-color PIV also has the advantage that velocity distributions in high speed flowfields can be measured simply and accurately by varying the time interval between two different laser beams due to its high signal-to-noise ratio and thereby less requirement of panicle pair numbers for a velocity vector in one interrogation spot. The velocity distribution in the Mach 2.0 supersonic nozzle has been measured and the over-expanded shock cell structure can be predicted by the strain rate field. These results are compared and analyzed with the schlieren photograph for the velocity distributions and shock location.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.2
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• pp.71-77
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• 2020

Background and Objectives OperaVOXTM (Oxford Wave Research Ltd.) is a portable voice analysis software package designed for use with iOS devices. As a relatively cheap, portable and easily accessible form of acoustic analysis, OperaVOXTM may be more clinically useful than laboratory-based software in many situations. The aim of this study was to evaluate the agreement between OperaVOXTM and Multi-Dimensional Voice Program (MDVP; Computerized Speech Lab) to assess voice quality before and after laryngeal microsurgery in patient with vocal polyp. Materials and Method Twenty patients who had undergone laryngeal microsurgery for vocal polyp were enrolled in this study. Preoperative and postoperative voices were assessed by acoustic analysis using MDVP and OperaVOXTM. A five-seconds recording of vowel /a/ was used to measure fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR). Results Several acoustic parameters of MDVP and OperaVOXTM related to short-term variability showed significant improvement. While pre-operative value of F0, jitter, shimmer, NHR was 155.75 Hz (male: 125.37 Hz, female: 183.37 Hz), 2.20%, 6.28%, 0.16, post-operative values of these parameter was 164.34 Hz (male: 129.42 Hz, female: 199.26 Hz), 2.15%, 5.18%, 0.14 Hz in MDVP. While pre-operative value of F0, jitter, shimmer, NHR was 168.26 Hz (male: 135.16 Hz, female: 201.37 Hz), 2.27%, 6.95%, 0.26, post-operative values of these parameters was 162.72 Hz (male: 128.267 Hz, female: 197.18 Hz), 1.71%, 5.36%, 0.20 in OperaVOXTM. There was high intersoftware agreement for F0, jitter, shimmer with intraclass correlation coefficient. Conclusion Our results showed that the short-term variability of acoustic parameters in both MDVP and OperaVOXTM were useful for the objective assessment of voice quality in patients who received laryngeal microsurgery. OperaVOXTM is comparable to MDVP and has high intersoftware reliability with MDVP in measuring the F0, jitter, and shimmer

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.101-106
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• 2019

Background and Objectives Reinke's edema is a benign vocal fold disease caused by an edematous laryngeal superficial layer of lamina propria. The first line treatment is cessation of smoking and laryngeal microsurgery. The aim of the study is to evaluate the feasibility and efficacy of percutaneous steroid injection via cricothyroid membrane in patients with Reinke's edema. Materials and Method From Jan 2010 to July 2018, 33 Patients with Reinke's edema managed by vocal fold steroid injection via the cricothyroid membrane were included in this study. We compared medical records of laryngoscopy, stroboscopy and Multi-Dimensional Voice Program analysis at pre-treatment and post-treatment. Subjective voice improvement was evaluated using Voice Handicap Index-30 (VHI-30). Results 75.7% of the patients showed partial response and 6.06% showed complete response. 93.94% were present smokers and only 4 patients ceased smoking after the treatment. In acoustic analysis, the pre-treatment mean value of jitter, shimmer, and noise to harmonic ratio was 2.30±3.21, 9.34±10.37, 1.11±2.90 each. The post-treatment value was 2.20±1.89, 6.96±5.30, 0.20±0.09 respectively and none of the parameters were statistically significant. For subjective symptom improvement, 25 (75.8%) patients showed a better score on post-treatment VHI-30 compared to pre-treatment. Conclusion According to our study, steroid injection is a relatively safe and effective procedure for patients with Reinke's edema. A vocal fold steroid injection via the cricothyroid membrane can be an alternative treatment option for those who are not able to undergo conventional laryngeal microscopic surgery, however cessation of smoking is necessary for effective treatment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.118-122
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• 2017

Background and Objectives : In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. Materials and Methods : This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. Results : Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), ${\Delta}$ jitter (p<0.001), ${\Delta}$ shimmer (p=0.031), and ${\Delta}$ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. Conclusion : Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.102-107
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• 2016

Background and Objectives : Vocal polyps are caused by inflammation induced by stress or irritation. Many patients with vocal polyps complain voice discomfort. For vocal polyps, surgery such as laryngeal microsurgery has been the mainstay of management. We analyzed the clinical features of vocal polyps, and how the size and location of vocal polyps affect the outcomes of surgery. Methods : We retrospectively reviewed 42 patients from March 2014 to December 2015, who were diagnosed as unilateral single vocal polyp. When we operated on a vocal polyp with laryngeal microscopy, we measured their size and location. The quality of voice was evaluated by GRABS scale, jitter, shimmer, NHR (noise to harmonic ratio), MPT (maximum phonation time), and VHI (voice handicap index) before operation and 4 weeks after operation. Results : When we divided the patients into large-sized vocal polyp group (the longest length >3 mm) and small-sized vocal polyp group (the longest length ${\leq}3mm$), all parameter differences tend to be greater at large sized vocal polyp. However, these differences were not statistically significant (p>0.05). When we divided into two groups depending on the volume of vocal polyp, no distinct tendency was found. When we compared the location (anterior, mid and posterior) of vocal polyp with the improvement of voice quality, more change was found at mid portion vocal polyp, except the difference of VHI. However, these differences were also not statistically significant (p>0.05). Conclusion : All parameter differences tend to be greater at large vocal polyp and polyp of the mid location.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.122-126
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• 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.

• Phonetics and Speech Sciences
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• v.12 no.1
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• pp.65-74
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• 2020

This study aims to compare the acoustic characteristics of vowel phonation in children with spastic and dyskinetic cerebral palsy (CP). Thirty-four children aged 4-12 years with CP participated in the study (spastic 26, dyskinetic 8). Voice samples for the acoustic analysis were extracted from a sustained vowel /a/. All acoustic measures were made using Praat. Group differences were compared by an independent t-test or Welch-Aspin test, if the equivalence assumption was not met. The results of this study are as follow. First, maximum phonation time(MPT) was significantly shorter for the dyskinetic CP than for the spastic CP. Second, shimmer percent was significantly increased in the dyskinetic CP than in the spastic CP. Lastly, there were no significant group differences in both the first formant and the second formant. These findings indicate that the dyskinetic CP has a poorer respiratory capacity and poorer laryngeal function than the spastic CP. On the other hand, both groups have a comparable ability to articulate the vowel /a/. The results of the present study help speech language pathologists identify the speech motor control ability of children with two types of CP (spastic and dyskinetic) and help to make an intervention plan associated with a specific type of CP.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.81-86
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• 2021

Background and Objectives Therapies have been reported to treat the glottal gap previously. However, these voice therapies showed the limits because many techniques focused only on one among breathing, resonance and phonation. In addition patients often have difficulties visiting hospital frequently. 'Gliding and humming' is vocal training technique that readjusts total vocal patterns such as breathing, resonance and phonation. This technique can be easily applied during short term sessions. The purpose of this study is to evaluate the efficiency of voice therapy with 'gliding and humming' for patients with glottic gap during short-term treatment sessions. Materials and Method Twenty-three patients with glottal gap were selected. Of all patients, 14 patients had sulcus vocalis and 12 patients had muscle tension dysphonia (MTD). Voice therapies were performed 1.9 sessions in average. GRBAS, jitter, shimmer, noise to harmonic ratio, semitone range, closed quotient_vowel and maximum phonation time were compared before and after the therapies. In addition, changes of glottal gap and MTD severity were evaluated. Results Statistically significant improvement was observed. MTD improvement was observed only among the patients with glottal gap improvement. Also sulcus vocalis group showed the statistically significant improvement. Conclusion 'Gliding and humming' was effective to the patients with glottic gap and sulcus vocalis. Also, among patients who have both glottic gap and MTD, the data suggests that voice therapy for glottic gap also makes improvement in MTD.