• Journal of Chest Surgery
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• 제26권5호
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• pp.409-412
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• 1993

We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.

• 말소리와 음성과학
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• 제3권3호
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• pp.133-140
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• 2011

Muscle misuse dysphonia (MMD) is defined as a behavioral voice disorder resulting from inappropriate contractions of intrinsic and/or extrinsic laryngeal muscles. The purpose of this study was to investigate the effect of motor learning guided laryngeal motor control therapy (MLG-LMCT) which is designed to improve an existing LMT and further the effective voice treatment on people with muscle misuse dysphonia. Forty-six people with MMD (M:F=16:30) participated in this study. The voice samples of the participants were recorded to investigate the effect of MLG-LMCT before and after the voice therapy. Voice samples were analyzed via electro-glotto-graph (EGG). Contact quotient (CQ), speed quotient (SQ), and waveform were reported. In addition, perceptual and acoustical evaluation were conducted to determine the change of voice improvement after treatment. The experimenter massaged the tensioned muscles around the neck. In order to find more proper phonation the experimenter showed the subjects their EGG wave forms as to whether or not they are moving the vocal folds to the appropriate position. Therefore, the EGG wave forms were used as a type of visual feedback. With the wave form, the experimenter helped subjects move the vocal folds and laryngeal muscles to find more proper voice production. The sensory stimuli from the experimenter gradually faded out. A paired dependent t- test revealed that there was significant differences in CQ between pre- and post-therapy. Perceptually, overall, rough, breathy, strain, and transition were significantly reduced. Acoustically, there were significant differences in Fo, jitter, shimmer, and NHR. After using MLG-LMCT, most of the subjects showed improvements in voice quality. The results from this study led us to the following conclusions: Motor learning guided laryngeal motor control therapy (MLG-LMCT) has reduces muscle misuse dysphonia. These results may occur because a visual feedback from EGG wave form can maintain the effect of the muscle tension reduction from laryngeal manual therapy. In case of people with MMD who reduced muscle tension from the therapy (LMT) but, not appropriately manipulating the location of larynx or adducting the vocal folds, MLG-LMCT might be an alternative therapy approach.

• 대한후두음성언어의학회지
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• 제21권2호
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• pp.133-138
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• 2010

Background and Objectives : High-speed imaging can be useful in studies of linguistic and artistic singing styles, and laryngeal examination of patients with voice disorders, particularly in irregular vocal fold vibrations. In this study, we introduce new laryngeal imaging systems which are commercially available high speed cameras connected with a laryngoscope. Materials and Method : The laryngeal images were captured from three different types of cameras. First, the adapter was made to connect with laryngoscope and Casio EX-F1 to capture the images using $2{\times}150$ Watt Halogen light source (EndoSTROB) at speeds of 1,200 tps (frame per second)($336{\times}96$). Second, Phantom Miro ex4 was used to capture the digital laryngeal images using Xenon Nova light source 175 Watt (STORZ) at speeds of 1,920 fps ($512{\times}384$). Finally, laryngeal images were captured using MotionXtra N-4 with 250 Watt halogen lamp (Olympus CLH-250) light source at speeds of 2,000tps ($384{\times}400$) by connecting with laryngoscope. All images were transformed into the Kymograph using KIPS (Kay's image processing Software) of Kay Pentex Inc. Results: Casio EX-F1 was too small to adjust the focus and screen size was diminished once the images were captured despite of high resolution images. High quality of color images could be obtained with Phantom Miro ex4 whereas good black and white images from Motion Xtra N-4 Despite of some limitations of illumination problems, limited recording time capacity, and time consuming procedures in Phantom Miro ex4 and Motion Xtra N-4, those portable devices provided high resolution images. Conclusion : All those high speed cameras could capture the laryngeal images by connecting with laryngoscope. High resolution images were able to be captured at the fixed position under the good lightness. Accordingly, these techniques could be applicable to observe the vocal fold vibration properties in the clinical practice.

• 대한의용생체공학회:의공학회지
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• 제14권4호
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• pp.387-396
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• 1993

In this paper, a laryngeal function identification system based-on the EGG signal is proposed as the decision basis whether the laryngeal function is normal or abnormal. The normal EGG signal is approved an autoregressive model which has the optimal order of 9. It can be analized by determining the transfer function. But it is not meaningful that the determi- nation is made using the transfer function of an autoregressive model on the abnormal EGG signal. The power spectral analysis was applied to discriminate the normal or abnormal cases. The SNR of the EGG signal was enhanced by the optimal position of electrodes.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.8.2-8
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• 1982

애성이란 음성의 질적 변화를 의미하는 것으로 이는 후두의 가장 대표적인 주 증상이다. 애성의 원인으로는 현재까지 알려져 있는것만 해도 약50 여종이 있다고 하며 그중 virus에 의한 상기도 감염증이 가장 많은 비율을 차지하고 있는 것으로 알려져 있고, 후두결절 및 풀립, 후두마비, 후두암, 후두유두종, 후두결핵등의 순으로 발생하는 것으로 알려져 있다. 최근 저자들은 본원에 입원중인 환자로서 애성 때문에 본 이비인후과로 진찰의뢰된 환자중 비교적 보기드문 질환과 동반된 애성환자 4예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 증예1. 29세 남자로서 교통사고로 후두부에 외상을 입은후 1 달만에 애성이 발생. 후두경 소견상 좌측성대의 paramedian paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예2. 53세 남자로서 clonorchis sinensis로 일반외과에서 전신 삽관마취하에 choledochostomy를 시행한 6 일후에 애성이 발생. 후두경 소견상 좌측성대의 median paralysis가 인정되었음. 증예3. 56세 남자로서 Aortic Aneurysm으로 내과에 입원한 환자로 입원전 3개월부터 애성이 발생. 후두경 소견상 좌측성대의 intermediate position paralysis 및 arytenoid cartilage의 전위가 인정되었음. 증예4. 74세 남자로서 Bronchogenic Ca.로 내과에 입원중인 환자로 입원 3년전부터 애성이 발생. 후두경 소견상 우측성대의 paramedian paralysis가 인정되었음

• 대한후두음성언어의학회지
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• 제25권2호
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• pp.96-98
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• 2014

Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

• 대한후두음성언어의학회지
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• 제9권1호
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• pp.79-85
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• 1998

Changes in the human voice occur between infancy and old age and reflect a myriad of biological changes that influence the size, shape, and physical properties of the larynx. The human larynx is located near the base of the neck and attached inferiorly to the trachea and opens superiorly into the pharynx. The larynx by the third month of fetal life has the same features recognizable at birth. The fundamental frequency of vocal fold vibration generally becomes higher in early age, lower in middle age, and higher in old age. These decreases in Fo undoubtedly result from a combination of factors, consisting of modest increase in length and mass of the muscle and connective tissues of the vocal fold. But the level of the larynx in the neck may be closely connected with Fo directly, high larynx in related with high pitch and low larynx with low pitch. The purpose of this study is to determine the developmental level difference from child to adult larynx using conventional radiography, and the change of speaking fundamental frequency from second decade to sixth decade.

• 말소리와 음성과학
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• 제13권2호
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• pp.91-101
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• 2021

본 연구의 목적은 자폐스펙트럼장애를 가진 아동의 후두 특성을 확인하고자 하였다. 자폐스펙트럼장애로 진단받은 2~4세 아동 8명과 같은 연령의 정상 대조군 42명을 포함하여 총 50명의 아동이 실험에 참여하였다. 모든 아동들은 경추와 후두의 중앙시상면의 X-ray 영상을 촬영하여 두 군의 후두 위치를 비교하였다. 또한 모음 연장발화 시 음성 샘플을 수집하여 음향 매개 변수들을 분석하였다. X-ray 검사 결과, 정상군의 설골 높이는 3세가 가장 낮았으며, 4세에 후두 높이가 상승하였다. 다른 한편으로, 외이도에서 설골까지의 거리는 4세가 가장 긴 것으로 나타났다. 이와는 대조적으로, 모든 연령대의 자폐스펙트럼장애군의 설골 높이는 정상군보다 낮았으며, 연령에 따른 설골 위치의 차이는 없었다. 음향학적 평가 결과, PFR, vFo, vAm은 정상 대조군에 비해 자폐스펙트럼장애군이 통계적으로 유의미하게 높게 나타났다. 결론적으로, 자폐스펙트럼장애 아동들의 낮은 후두 높이는 언어발달의 지연과 관련이 있는 것으로 사료된다. 음향학적 변수들 중 음성 조절기능을 보여주는 PFR, vFo, vAm은 정상 아동과 자폐스펙트럼장애 아동의 음질 차이를 보여주는 voice marker로 생각된다.

• 디지털융복합연구
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• 제14권12호
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• pp.369-375
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• 2016

본 연구는 환자의 경추보호대 착용 여부에 따른 후두마스크기도기(LMA)와 I-gel, Streamlined Liner of the Pharynx Airway(SLIPA) 등 3가지 성문위기구의 삽관 용이성을 비교하기 위해 시행되었다. 응급의료현장에서 활동 중인 119 구급대원 39명에게 3가지 성문위기구에 대한 짧은 교육을 시행한 후 삽관시간과 삽관시도횟수를 측정하였다. 삽관시간은 중립위와 경추보호대 착용 시 모두 I-gel($10.5{\pm}2.2$, $11.4{\pm}5.7$), SLIPA($12.3 {\pm}5.1$, $12.0{\pm}6.8$), LMA($17.2{\pm}3.2$, $18.5{\pm}5.5$) 순으로 빨랐다 (p<0.05). 각 기도기별 중립위와 경추보호대 착용 시 삽관시간의 차이는 없었다. 결론적으로 I-gel과 SLIPA가 LMA보다 중립위와 경추보호대 착용 시 모두에서 삽관시간이 더 빠른 결과를 보였다.

• 음성과학
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• 제9권3호
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• pp.87-97
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• 2002

The purpose of this study is to analyze the speech duration in Korean-speaking aphasics. Five patients with nonfluent aphasia (2 with traumatic brain injury and 3 with strokes) and five normal adults participated in this experiment. The mean age in patients with nonfluent aphasia was $45.8\pm2.3$ years and $47.4\pm2.3$ years for the normal adults. The Computerized Speech Lab was used to evaluate the acoustic characteristics of the subjects. Voice onset time, vowel duration, total duration, hold and consonant duration were evaluated for the monosyllabic and the polysyllabic words. The patients with nonfluent aphasia did not show the voicing bar on hold area, however, it was seen in the normal persons in the intervocalic position. Explosion duration of glottalized stops in the intervocalic position was significantly prolonged in nonfluent aphasics in comparison with the normal persons. This suggestes that the laryngeal adjustment is disturbed in these patients. Consonant duration, vowel duration, and total duration of the polysyllabic words were significantly longer in the patients with nonfluent aphasia than those of the normal persons. These results demonstrate the disturbances in controlling articulatory muscles during sound production in patients with nonfluent aphasia. The objective and quantitative analysis based on the acoustic characteristics of nonfluent aphasics, will be very useful in therapeutic planning and on the the effects of speech therapy.