• 음성과학
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• 제5권1호
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• pp.121-139
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• 1999

Our experimental subject was a laryngectomee who had undergone total laryngectomy with $PROVOX^{(R)}$ insertion, and learned esophageal speech after the surgery, so he could produce both $PROVOX^{(R)}$ voice and esophageal voice. With this subject's production of $PROVOX^{(R)}$ and esophageal voice, we are to compare the acoustic and aerodynamic characteristics of the two voices, under the same physical conditions of the same person. As a result, the fundamental frequency of esophageal voice was 137.2 Hz, and that of $PROVOX^{(R)}$ was 97.5 Hz. $PROVOX^{(R)}$ voice showed lower jitter, shimmer and NHR than esophageal voice, which means that $PROVOX^{(R)}$ voice showed better voice quality than esophageal voice. In spectrographic analysis, the formation of formants and pseudoformants were more distinct in esophageal voice and several temporal aspects of acoutic features such as VOT and closure duration were more similar with normal voice in $PROVOX^{(R)}$ voice. During the sentence utterance, esophageal voice showed longer pause or silence duration than $PROVOX^{(R)}$ voice. Maximum phonation time and mean flow rate of $PROVOX^{(R)}$ voice were much longer and larger than esophageal voice, but mean and range of sound pressure level, subglottic pressure and voice efficiency were similar in the two voices. Glottal resistance of esophageal voice was much larger than $PROVOX^{(R)}$ voice which showed still larger glottal resistance than normal voice.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.54-57
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• 2022

The coronavirus disease (COVID-19) by severe acute syndrome coronavirus-2 (SARS-CoV-2) occurs the unprecedented pandemic during recent two years and the WHO declared a global pandemic of COVID-19 in March 2020. The most common sampling sites in COVID-19 test are the oropharynx and nasopharynx. We recently encountered a total laryngectomee who had a positivity COVID-19 diagnostic test from the tracheostoma, on the other hand, false negativity from the nasal cavity. The meaning of this case is that accurate screening test could be achieved by performing a test through the tracheostoma as well as nasal cavity or oropharynx. We also would like to discuss the accurate testing methods of patients whose airflow has distorted due to surgery, the management method of these patients, and the need of further research in the COVID-19 pandemic period with relevant literature reviews.

• 대한두경부종양학회지
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• 제16권2호
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• pp.191-195
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• 2000

Objectives: Despite various attempts to preserve the normal voice in advanced laryngeal cancer, it is inevitable for many advanced laryngeal cancer patients to undergo total laryngectomy and thus making a trade off between quality and quantity of life. Laryngectomees are faced with voice loss, change in physical appearance and health deterioration which hinder their efforts to rehabilitate back into their family and employment leading to poor quality of life. The objectives of this study were to evaluate the quality of life in long term surviving laryngectomees to, define the factors which are most important in determining their present quality of life and to propose a theoretical model for quality of life after laryngectomy in Korea. Materials and Methods: From 1986 to 1995, 120 laryngectomees with no evidence of disease were followed up for at least 3years were evaluated. Each of 15 quality of life domains with a total of ten points were given for a quality of life score. Results: There was no significant difference in the physical-mental adaptation index such as general health and mental health between the laryngectomees and control group(p>0.05). However, social adaptation index such as social activity, occupational status and economic status for laryngectomees were significantly lower with 2.3, 3.5, and 4.4 points compared to control group with 8.5, 7.6, and 7.1 points respectively(p<0.05). Conclusion : Vocational and social rehabilitation should be emphasized with highest priority for improving their economic status and thus improving their quality of life.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.21-27
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• 2008

Total laryngectomy is the most useful procedure tor advanced laryngopharyngeal cancer, but it remains the major problem such as loss of voice. Voice restoration is essential for every patients who undergo a total laryngectomy. Ideal voice rehabilitation methods can resolve three factors. First, every laryngectomee can produce voice sufficient for communication, second every patient should be allowed to use both hands freely during phonation, and last, the voice restoration methods should be easy and safe without complication during and after treatment. Among various voice rehabilitation procedures during or after total laryngectomy, it can be divided electronic and pneumatic methods. In pneumatic methods, there are also divided both pulmonary air and non-pulmonary air methods. The non-pulmonary air methods include esophageal speech, buccal speech, and pharyngeal speech. Pulmonary air methods are divided into surgical and non-surgical such as pneumatic speech aid. In the surgical methods, there are neoglottic operation, tracheopharyngeal shunt, and tracheopharyngeal shunt operations. Recently, tracheoesophageal shunt with or without prosthesis are being recognized the most effective method. Blom-Singer low pressure prosthesis, Panje button, and Provox are well known types of prosthesis in the tracheoesophageal shunt operation. Amatsu method is a kind of famous tracheoesophageal shunt method without using prosthesis. Authors tried to review the published articles for evaluation of effectiveness and problems of tracheoesophageal shunt operation with or without prosthesis. In conclusion, indwelling type of prosthesis and pharyngeal myotomy and plexus neurectomy are recommended for higher success rate during tracheoesophageal puncture procedure. More over, Amatsu method is also one of the recommended voice rehabilitation procedure during total laryngectomy. In this situation, pharyngeal myotomy and plexus neurectomy may be helpful for better fluent communication.

• 대한기관식도과학회지
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• 제1권1호
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• pp.136-141
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• 1995

Tracheostomal stenosis after total laryngectomy is a distressing complication which con-tributes significantly to both psychosocial and physical morbidity according to nature and severity in laryngectomee. Sternal stenosis will compromise not only optimal air exchange, crust formation but also the ability to clear tracheobronchial secretion, so pneumonia and atelectasis will develop. Having a number of procedure recommended for correction of such stenosis with limited results. We developed new technique which is based on tracheal advancement flap had been ap-plied to 12 patients, successfully. We think that total or partial tracheal advancement flap technique Is useful for widening the stoma and advantages of this method are following. 1. Simple technique. possible under local anesthesia 2. Healthy tracheal ring facilities width control 3. Less chance of refractory scar stenosis 4. Tracheoesophageal shunt can be constructed after the partial advancement flap.

• 말소리와 음성과학
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• 제5권4호
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• pp.25-32
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• 2013

This research is aimed at finding the acoustic characteristics of different voice rehabilitation techniques, the electrolaryx (EL), standard esophageal (SE), and tracheoesophageal (TE), used on 17 patients with laryngectomees. The analysis of the voice qualities was achieved using MDVP. In order to compare the acoustic characteristics, patients were asked to produce the vowel /a/ sound. The acoustic analysis included fundamental frequency (f0), jitter, shimmer, and noise-to-harmonic ratio (NHR). The main acoustic results showed no significant statistical differences between the average measurements of SE and TE speakers. It was found that the current study showed the same tendency found in previous studies. There was also a significant difference between SE and EL speakers. On the other hand, there were no significant statistical differences between the average measurements of TE and EL speakers on all acoustic measurements. This research will contribute to establishing a baseline related to speech characteristics in voice rehabilitation for patients with laryngectomees. In future, the present findings and issues should be considered in the context of gender. Specifically, the number of women who are diagnosed with laryngeal cancer continues to rise and their acoustic characteristics may indeed differ from those of men.

• 대한후두음성언어의학회지
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• 제9권2호
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• pp.142-146
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• 1998

Background : It has been established that the fundamental frequency(Fo) of the vowels varies systemically as a function of vowel height. Specifically, high vowels have a higher Fo than low vowels. Two major explanations or hypotheses dominate contemporary accounts of fired to explain the mechanisms underlying intrinsic variation in vowel Fo, source-tract coupling hypothesis and tongue-pull hypothesis. Objectives : Total laryngectomy surgery necessiates removal of all structures between the hyoid bone and the tracheal rings. Therefore, the assumption that no direct interconnection exists between the tongue and pharyngoesophageal segment that would mediate systematic variation in vowel Fo appears quite reasonable. If tongue-pull hypothesis is correct, systemic differences in Fo between high versus low vowels produced by esophageal speakers would not Or expected. We analyzed the Fo in the vowels of esophageal voice. Materials and method : The subjects were 11 cases of laryngectomee patients with fluent esophageal voice. The five essential vowels were recorded and analyzed with computer speech analysis system(Computerized Speech Lab). The Fo was measured using acoustic waveform, automatically and manually, and narrow band spectral analysis. Results : The results of this study reveal that intrinsic variation in vowel Fo is clearly evident in esophageal speech. By analysis using acoustic waveform automatically, the signals were too irregular to measure the Fo precisely. So the data from automatic analysis of acoustic waveform is not logical. But the Fo by measuring with manually calculated acoustic waveform or narrowband spectral analysis resulted in acceptable results. These results were interpreted to support neither the source-tract coupling nor the tongue-pull hypotheses and led us to offer an alternative explanation to account for intrinsic variation of Fo.

• 한국음향학회지
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• 제26권5호
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• pp.182-187
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• 2007

본 연구는 후두적출술 후 성대를 상실한 후두적출자들이 식도를 통하여 끌어들인 공기로 발성하는 식도발성 발화의 명료도를 조사해 보고자 하였다. 정상 청력을 가진 3명의 청취자가, 식도발성을 사용하는 화자 10인이 산출한 자음+모음+모음(CVV), 모음+자음+모음(VCV)의 무의미 2음절어를 듣고 그 내용을 기록하였다. 그 결과, 식도발성의 전체적인 명료도는 27%로 나타났다. 조음방법적 측면에서는 파찰음이 가장 높은 명료도를 보였고 마찰음이 가장 낮은 명료도를 보였다. 조음위치적 측면에서의 명료도는 경구개음이 가장 높고, 치경음이 가장 낮은 것으로 나타났고, 전반적으로 경음의 명료도가 높고, 격음의 명료도가 매우 낮은 것으로 나타났다. 그리고, 음절내 3위치 측면에서는 CVV 음절보다 VCV 음절에 나타난 자음이 더 높은 명료도를 보였다. 식도발성 발화자가 보이는 명료도의 문제는 대개 충분한 공기량을 확보하지 못함으로써 나타나는 것으로 판단된다. 따라서, 정확한 조음동작의 훈련 뿐 아니라, 충분히 공기를 유입하는 훈련을 병행함으로써 명료도를 개선시키도록 노력하는 것이 바람직할 것이다.