• 대한후두음성언어의학회지
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• 제33권2호
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• pp.89-96
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• 2022

Background and Objectives The quality of life after thyroidectomy, such as voice change, is considered to be as important as control of the disease. In this study, we aimed to evaluate changes in both subjective and objective voice parameters after thyroidectomy resulting in normal morbidity of the vocal cords. Materials and Method In this prospective cohort study, 204 patients who underwent thyroidectomy with or without central neck dissection at a single referral center from Feb 2015 to Aug 2016 were enrolled. All patients underwent prospective voice evaluations including both subjective and objective assessments preoperatively and then at 2 weeks, 3, 6, and 12 months postoperatively. Temporal changes of the voice parameters were analyzed. Results Values of the subjective assessment tool worsened during the early postoperative follow-up period and did not recover to the preoperative values at 12 months postoperatively. The maximal phonation time gradually decreased, whereas most objective parameters, including maximal vocal pitch (MVP), reached preoperative values at 3-6 months postoperatively. The initial decrease in MVP was significantly greater in patients undergoing total thyroidectomy, and their MVP recovery time was faster than that of patients undergoing lobectomy (p=0.001). Patients whose external branch of the superior laryngeal nerve was confirmed intact by electroidentification showed no difference in recovery speed compared with patients without electroindentification (p=0.102), although the initial decrease in MVP was lower with electroidentification. Conclusion Subjective assessment in voice quality and maximal phonation time after thyroidectomy did not show recovery to preoperative values. Aggravation of MVP was associated with surgical extent and electroidentification.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1982년도 제16차 학술대회연제순서 및 초록
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• pp.11.2-12
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• 1982

최근 우리나라에 있어서도 후두미세수술의 발달로 음성외과 분야에 대한 관심이 높아졌으며 음성장애 환자의 진단 및 치료면에서도 괄목할 만한 발전을 가져왔다. 우리는 작금의 음성외래에서 진단되는 음성장애 환자중에서 특히 성대의 유리연(遊離緣)을 따라서 평행하는 선상(線狀)의 성대구 (聲帶溝)를 보게되는데 이와같이 성문의 폐쇄부전을 동반하는 성대구증 (Sulcus Vocalis)은 1901 년 Salvi에 의해서 처음으로 명명보고된 이래로 유럽과 일본등에서 다수 보고된 바있으나. 우리나라에서는 비교적 관심이 적었던 질환으로 그 뚜렷한 원인과 치료에 대해서는 아직도 정설이 없는 상태이다. 이에 본 교실에서는 1981년 5월부터 1982년 3월까지 본원 음성언어연구실로 내원한 성대구증환자 35예에 대하여 일련의 음성검사를 시행하여 약간의 치험을 고찰한 바 있기에 그 결과를 보고하는 바이다. 1 ) 발생 빈도는 음성 장애를 주소로 내원한 290 예의 환자 중 35예로써 약 12 %였다. 2) 발병연령은 10세 이하에서 19예 (54%)로 가장 많았으며 다음은 10대, 20대의 순이였다. 3 ) 발병연령은 대부분의 예에서 불명이었으나 4예에서는 홍역 후에, 3예에서는 심한 감기 후에 병발했으며, 2 예는 선천적인 것으로 사려되었다. 4) 예중 25예 (71 %)에서 양측성이었고, 좌,우 편측성인 경우가 각각 8예 (23 %), 및 2예 (6 %)였다. 5 ) 임상증상은 거의가 애성을 주소로 하고 있었으며 7 예에서는 만성후두염을 동반하고 있었다. 6 ) 공기역학적검사에서는 20 예(57 %)에 서 최대발성지속시간 (Maximal Phonation time)이 감소되어 있었고, 발성율(發聲率, Phonation Quotient)은 22예(63 %)에서 증가되었으며, 발성시평균호기유율(Mean Air Flow Rate)은 23예 (66 %)에서 증가되었다. 7 ) 스트로보스코피(Stroboscopy) 를 시행할 수 있었던 33예 중 31예 (93%)에서 성문폐쇄부전 (glottic chink)이 있었으며 양측성대의 진동성은 거의 전례에서 규칙적 (regular)이었고, 4예(12 %)에서 비대칭(asymmetric)이었으며, 진폭 (amplitude) 은 5 예 (21 %)에서 감소되었으며, 점막파동(mucosal wave) 은 24 예 (73 %)에서 감소되었다. 8) 치료로서 상기 환자중 5예에서 성대내 테프론(Teflon) 주입을 실시하였고 1예에서 성대구절제술(Sulcusectomy)를 실시하였는데 테프론을 주입한 1예에서 증상의 호전이 있었을 뿐 다른 예에서는 효과가 뚜렷치 않아서 앞으로의 원격성적이 요망되었다.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1996년도 제6회 학술대회 심포지움
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• pp.85-85
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• 1996

편측성대마비에 대한 치료방법으로 외측에 위치한 성대를 수술적으로 교정하려는 시도는 최근 활발하게 진행되어 Teflon 등을 이용한 성대내 이물주입술, 제Ⅰ형 갑상연골 성형술 및 피열연골 내전술등의 시술들이 시행되어 왔다. 저자들은 최근 후두와 종양으로 개두술을 시행받은 후 발생한 재발성 흡인성 폐렴 및 애성을 주소로 내원한 49세 남자환자를 원인 미상의 우측 편측성 성대마비로 진단하고 제Ⅰ형 갑상연골 성형술을 시행한 후 흡인성 폐렴 및 애성 등의 증상의 현저한 호전을 관찰할 수 있었으며, 술전 Maximal comfortable phonation time(MPT)이 6.24초에서 술후 17초로 증가하는 등 좋은 결과를 얻은 1례를 치험 하였기에 보고하는 바이다.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1998년도 제10회 학술대회 심포지움
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• pp.196-196
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• 1998

후두전적출술후 음성재활방법은 식도발성, 기관식도발성, 전기후두발성, 기체역학형 인공후두 발성등이 있다. 본 연구에서는 각각의 음향학적 특성과 어떤 방법이 음성의 발성에 효과적이고, 음의 고저를 잘 나타낼 수 있는 지를 연구하였고 식도발성과 기관식도발성이 동시에 가능한 환자에서도 위와 같이 어떤 것이 음의 고저를 잘 나타낼 수 있는 지를 보고자 본 연구를 시행하였다. 식도발성자 5명, 기관식도발성자 7명(2가지가 다 가능한 발성자 2명을 포함하여), 전기후두발성자 3명과 공기를 이용한 인공후두(Pneumatic speech aid) 발성자 3명을 대상으로 하여 Maximal phonation time(sec), Sound intensity (dB SPL), Fundemental frequency (F0), Jitter(%), Shimmer(%)를 Matlab V5.1을 기초로 저자들이 고안한 프로그램인 Laryngeal analyser Vl.0 으로 측정하였다. 각각의 발성법에 따라 특징적인 변수의 차이가 있었으며 그중 공기를 이용한 인공후두 발성자에서 음의 고저를 가장 잘 표현하였다. (p<0.01). 그리고 식도발성과 기관식도발성을 같이 사용할 수 있는 2명에서 식도발성이 기관식도발성보다 더 효과적으로 음의 고저를 잘 나타냈다.

• 대한후두음성언어의학회지
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• 제18권1호
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• pp.44-50
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• 2007

Background and Objectives: The 585-nm pulsed dye laser (PDL) has recently been adopted by otolaryngologists because of its epithelial-sparing properties. Many authors have reported the use of PDL for treatment of various vocal cord lesions. This purpose of this study is to examine the effectiveness of 585-nm PDL in the treatment of vocal polyp. Materials and Methods: Eight patients with vocal polyp were treated with 585-nm PDL from Sep. 2006 to Nov. 2006 in Yong-dong Sevrance hospital. 5 of them went through local anesthesia and 3 of them went through general anesthesia. In order to control laser fiber, flexible digital transnasal laryngoscope was applied under local anesthesia and general anesthesia using LMA, and micromanipulator was used under general anesthesia using endotracheal tube. The evaluations of vocal function was done at pre-and postoperation. Results: All patients improved in the perceptual evaluation of voice after PDL surgery. The aerodynamic study revealed that 5 of 8 patients showed improvement in maximal phonation time, and 6 of 8 showed improvement in mean airflow rate during phonation. The acoustic analysis revealed that all patients showed improvement in Jitter and Shimmer, and 7 of 8 showed improvement in noise to harmony ratio. Conclusion: This study demonstrates promising results in the efficacy of 585-nm PDL for the treatment of vocal polyps, and it illustrates a new option for vocal polyp treatment as well as the advantage of PDL surgery.

• 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.

• 대한후두음성언어의학회지
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• 제14권2호
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• pp.94-97
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• 2003

Background and Objectives : Bowing of the vocal fold, a bowed edge of the vocal fold results from various disorder causes glottic incompetence resulting in voice disorders. The results of treatment were not satisfactory even though a variety of methods of treatment were applied. The goal of this study is to evaluate of efficacy of the non-surgical, voice therapy in patients with vocal fold bowing. Materials and Method : Twenty two patients of vocal fold bowing not resulting from vocal fold palsy and sulcus vocalis were analyzed. After voice therapy and medical treatment, parameters of perceptual, acoustic, aerodynamic analysis and stroboscopic findings were compared those of pretreatment results. Results and Conclusion : Jitter, shimmer and maximal phonation time were significantly improved and subjective satisfaction was improved in 73% of patients. In the videostroboscopic examination, vocal fold gap was decreased in 27% of patents. The result of this study indicates that voice therapy alone has effect in treatment of vocal fold bowing. Voice therapy is one of the mainstay of treatment of vocal fold bowing.

• 대한후두음성언어의학회지
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• 제8권1호
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• pp.38-43
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• 1997

Backgroud : Now a days, most studies for professional voice user have been performed after artificial voice abuse without consideration of environmental and personal factors, and occupational specificity, therefore those studies have some problems. Objectives : To make a basic guideline for the management of untrained professional voice user, practically we ananalyzed the voice of experimental group. Materials and methods : Just after working, the sustained vowel sounds of the 15 female telephone operators (subjective group) and the 20 normal female persons (control group) were analysed, using a history paper, acoustic analyzer and videostroboscopy. Results : The most common symptom in subjective group was dysphonia. Stroboscopic findings in subjective group were as following ; posterior chink 11 cases (73%), incomplete closure 2 cases (13%), anterior chink 1 case (7%). The mean maximal phonation time in telephone operators was 12.8 seconds and in control group was 16.8 seconds. Jitter, pitch pertubation quotient (PPQ), shimmer and amplitude pertubation quotient (ASQ) were significantly increased in subjective group than control group, but there is no difference between two group in fundamental frequency and noise to harmonic ratio. Conclusion : Untrained professional voice user needs professional career guidance and counseling. And when we manage the untrained professional voice user, we should consider specific occupational, personal and environmental factors as well as laryngeal factors.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.64-68
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• 2000

Background and Objectives : To assess the role of altered vocal function in transient voice change after short-term endotracheal intubation, we evaluated acoustic parameters, aerodynamic parameters, and laryngoscopic characteristics preoperatively and postoperatively. Materials and Methods : Vocal function of 10 patients undergoing tympanoplasty and mastoidectomy using general anesthesia and endotracheal intubation were studied preoperatively, at 1day and 7 days after extubation. Acoustic analysis, aerodynamic study, and telescopic examination were used to assess vocal function. Results : In acoustic parameters, there was no significant difference between preoperative and postoperative measures. However, in subglottic pressure, ere was a significant decrease at 1 day after extubation and this change was return to preoperative value at 7 days after extubation. MPT(Maximal Phonation Time), MER(Mean flow Ratio), and VC(Vital Capacity) were decreased 1 day after extubation but did not show statistically significant change. Three of 10 patients manifested a vocal fold edema and injection 1 day after extubation. Conclusions : Subglottic pressure revealed a significant decrease at 1 day after extubation. And this change was correlated with laryngeal morphologic change and decrement in pulmonary function.

• 대한후두음성언어의학회지
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• 제9권1호
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• pp.47-52
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• 1998

Objectives : To compare the objective differences in voice quality and voice problems between clergies and normal male control group. Materials and Methods : The sustained vowel sound of 46 clergies and 40 normal persons were analyzed, using a videostroboscopy and acoustic analyzer. Together with these analyses, a questionnaire associated with current and past voice problems was handed over to the patients. Results : The most common symptom in subjective group was the voice fatigue. Stroboscopic findings in subjective group were as following 23 cases(50%) of pachydermia, 17 cases(37%) of phase difference, 12 cases(25%) of anterior-posterior contracture, 6 cases(13%) of vocal polyp and 3 cases(7%) of vocal nodule. The mean maximal phonation time in clergies was 17.8 seconds and in control group was 19 seconds. litter, pitch perturbation quotient and shimmer were significantly increased in subjective group than in control group(p<0.05), but there were no significant differences between two groups in fundamental frequency, vFo, amplitude perturbation quotient and noise to harmonic ratio. Conclusion : In the clergies using loud and forceful voice, vocal polyp and functional voice disorder findings were frequently noted in stroboscopic examination. litter and shimmer, reflecting the roughness of voice, were increased in acoustic analysis. Therefore, clergies, classified into untrained professional voice users, need professional career guidance and counseling.