• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.27 no.1
• /
• pp.5-10
• /
• 2016

Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.24 no.2
• /
• pp.83-87
• /
• 2013

The term "phonosurgery," coined in the early 1960s, refers to surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (endoscopic microsurgery of the vocal folds), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection of medications as well as synthetic and organic biologic substances), and reinnervation of the larynx. Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria. The purpose of the surgery is usually to improve the vibratory characteristics of the layered microstructure of the vocal folds. Phonomicrosurgery has developed from convergence of microlaryngoscopic surgical technique theory and the mucosal wave theory of laryngeal sound production. Improvements in technology (i.e., laryngoscopes, handled instruments, and lasers), which in part arise from developments in more frequently performed minimally invasive surgical procedures, will probably facilitate the next generation of procedural innovations. The best methods of optimizing phonosurgical outcomes include making an accurate diagnosis, completing a comprehensive voice evaluation, providing sufficient preoperative therapy, carefully selecting patients to undergo phonomicrosurgical procedures, and requiring sufficient postoperative rest and therapy. Phonomicrosurgery will continue to evolve as a result of the interdependent collaboration of surgeons with voice scientists, speech pathologist, and other voice professionals.

• Speech Sciences
• /
• v.1
• /
• pp.153-200
• /
• 1997

In languages such as Japanese, it is very common to observe that short peripheral vowel are completely voiceless when surrounded by voiceless consonants. This phenomenon has been known as Montreal French, Shanghai Chinese, Greek, and Korean. Traditionally this phenomenon has been described as a phonological rule that either categorically deletes the vowel or changes the [+voice] feature of the vowel to [-voice]. This analysis was supported by Sawashima (1971) and Hirose (1971)'s observation that there are two distinct EMG patterns for voiced and devoiced vowel in Japanese. Close examination of the phonetic evidence based on acoustic data, however, shows that these phonological characterizations are not tenable (Jun & Beckman 1993, 1994). In this paper, we examined the vowel devoicing phenomenon in Korean using data from ENG fiberscopic and acoustic recorders of 100 sentences produced by one Korean speaker. The results show that there is variability in the 'degree of devoicing' in both acoustic and EMG signals, and in the patterns of glottal closing and opening across different devoiced tokens. There seems to be no categorical difference between devoiced and voiced tokens, for either EMG activity events or glottal patterns. All of these observations support the notion that vowel devoicing in Korean can not be described as the result of the application of a phonological rule. Rather, devoicing seems to be a highly variable 'phonetic' process, a more or less subtle variation in the specification of such phonetic metrics as degree and timing of glottal opening, or of associated subglottal pressure or intra-oral airflow associated with concurrent tone and stricture specifications. Some of token-pair comparisons are amenable to an explanation in terms of gestural overlap and undershoot. However, the effect of gestural timing on vocal fold state seems to be a highly nonlinear function of the interaction among specifications for the relative timing of glottal adduction and abduction gestures, of the amplitudes of the overlapped gestures, of aerodynamic conditions created by concurrent oral tonal gestures, and so on. In summary, to understand devoicing, it will be necessary to examine its effect on phonetic representation of events in many parts of the vocal tracts, and at many stages of the speech chain between the motor intent and the acoustic signal that reaches the hearer's ear.