• 재활복지
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• 제22권1호
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• pp.169-194
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• 2018

본 연구는 세 명의 연하장애환자들을 대상으로 후두관련기능의 개선을 목표로 한 치료적 노래부르기 중심의 음악중재를 시행하고, 각 사례 별로 관찰된 변화를 기술한 개별 사례연구이다. 중재는 개별 세션의 형태로 매 회기 30분, 주 3회씩 총 12회기 동안 진행되었으며, 시행된 프로그램은 호흡근 이완, 구강근육운동, 후두상승 유지를 위한 발성과 치료적 노래부르기 등의 순서로 구성되었다. 대상자들의 연하 및 말하기 기능, 삶의 질 등의 변화를 알아보기 위해 매 회기 후두교호운동속도, 최대발성시간, 음성 질 관련 항목 등을 측정하였고, 중재 전후로 설문을 통해 삶의 질을 평가하였다. 중재 과정에서 대상자의 기능적 특성에 따라 구분되는 변화의 양상이 관찰되었고, 중재 후에는 모든 대상자의 후두교호기능 및 음성 질 지표 측정값에 변화가 있었으며, 연하관련 삶의 질 평가점수도 증가하였다. 본 연구를 통해 치료적 노래부르기 중심의 음악중재프로그램이 다양한 원인에 의한 연하장애환자들의 후두관련기능 및 삶의 질 영역에 공통적으로 혜택을 줄 수 있다는 점과, 중재 시 대상자의 기능적 특성에 따라 고려해야 할 부분에 대해 구체적으로 알 수 있었다.

• 대한후두음성언어의학회지
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• 제32권2호
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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.

• 말소리와 음성과학
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• 제9권4호
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• pp.99-106
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• 2017

Clinical data about vocal nodules have seldom been reported, even though vocal nodules are commonly diagnosed in outpatient speech and voice clinic. This study aims to investigate clinical characteristics of the patients who are diagnosed with vocal nodules. This study analyzed the data for 10 years from the 319 patients diagnosed with vocal nodules (45 males and 274 females with the mean age of 39.4 ranging from 2 to 83) in terms of gender, age, occupation, voice change initiation pattern, change with time, throat clearing, smoking history, type of voice abuse, acoustic analysis, maximum phonation time, GRBAS, and VHI. Thirteen patients (4.08%) had unilateral vocal nodule and 306 patients (95.9%) had bilateral vocal nodule, the majority of which had a pattern of asymmetry (73.9%). The glottal closure pattern was hourglass in 72.1% of patients, posterior chink in 17.9% of patients, and irregular in 7.9% of patients. The most common occupational category was professional voice users (43.4%). The voice abuse pattern included excessive talking in 96 patients (76.8%), loud voice in 78 (62.4%) patients, and excessive singing in 17 patients (21.6%). The patients showed worse scores in G, B, and S than in R and A for the GRBAS evaluation. The most recommended treatment for vocal nodules was voice therapy. The current clinical data will be helpful for treatment planning for the patients of vocal nodule.

• 대한후두음성언어의학회지
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• 제11권2호
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• pp.146-160
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• 2000

The current study aimed to establish rationales for using three different voice therapies (resonant voice, accent method, and tongue-tip trills) by comparing the aerodynamic, and vocal fold closure characteristics under three therapies. A total of 8 male under/graduate students(tenors) participated as subjects. In order to compare aerodynamic characteristics, air flow rates and subglottal pressures were measured using Phonatory function analyzer under three therapy conditions. The characteristics of vocal fold closure patterns also were examined by comparing closed quotients(CQ) measured by Electroglottograph(EGG) under three therapy conditions. However, maximum phonation time (MPT) was measured under only resonant voice and tongue-tip trills using Aerophone II. The results are summarized as follows : 1) CQ, subglottal pressure and MPT decreased significantly under resonant voice as compared with throat voice, but the air flow rate increased significantly under resonant voice. 2) CQ decreased significantly under accent method as compared with throat voice, but both air flow rate and subglottal pressure increased significantly under accent method. 3) Both CQ and MPT decreased significantly under tongue tip trills as compared with throat voice, but air flow rate and subglottal pressure increased significantly under tongue-tip trills. Clinical implications of results were discussed in light of differential effects of three voice therapies.

• 대한후두음성언어의학회지
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• 제9권2호
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• pp.128-133
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• 1998

Background and Objectives : Despite of numerous treatment modalities for glottic insufficiency, it still remains unresolved problem. Recently, autologous collagen injection was introduced as a new treatment for glottic insufficiency. This study was attempted to evaluate the efficacy of this treatment modality. Materials and Methods : Ten patients diagnosed as symptomatic sulcus vocalis with glottic insufficiency and agreed with this procedure were selected. Injectable collagen was obtained from the patient's dermis. It was injected into the pathologic area of the vocal fold. After injection, 4 of 10 patients were 1311owe4 up more than 5 months, and their voice were evaluated prior to injection and at 5 months after injection, using subjective, perceptual, aerodynamic, acoustic and videostroboscopic assessments. Results : In the aerodynamic assessment, 2 of 4(50%) patients was improved in MFR(mean flow rate), but no change was noted in MPT(maximum phonation time). In the acoustic assessment, no definite improvement was noted. In the subjective and perceptual assessments, 2 of 4(50%) patients was improved. In the videostroboscopic assessment, chink was reduced but still remained. Serious complication was not noted. Conclusion : Autologous collagen injection was reported as ideal treatment for glottic insufficiency, but our results were relatively unsatisfactory. But considering that our study is preliminary, it is too hasty to determine the efficacy of autologous collagen injection. We think that further study is required.

• 음성과학
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• 제15권4호
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• pp.159-170
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• 2008

The purpose of this study was to find out the ability of coordination of the articulatory motor and the ability of control of the respiration and laryngeal for spastic dysarthria by acoustic analysis. The sustained of vowel /a/ and repetition of syllable /pa/ in 15 normal and 10 spastic dysarthria were measured. Multi-Speech, MDVP, and MSP were used for data recording and analysis. As a result, the mean DDK rate in the spastic group was significantly slower than in the normal. The maximum phonation time in the spastic group ($4.80{\pm}1.94$) was shorter than in the normal ($11.20{\pm}3.72$). The DDKjit in the spastic group was significantly higher than in the normal. The DDKsla was reduced in the spastic group. The mean syllable duration in the spastic group (146.2ms) was significantly longer than in the normal (75.8ms). The mean energy was reduced in the spastic group. The range of Fo was greater than in the normal. The frequency perturbation (jitter, vFo) and amplitude perturbation (shimmer, vAm) were higher than in the normal group. The NHR was higher than in the normal group. The parameters of this were significantly difference between the spastic dysarthria and the normal (p<0.05). Finally, the spastic dysarthria has short respiration, slow speech rate, and voice quality problem. The these results will help to establish a plan and the intervention of treatment.

• 말소리와 음성과학
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• 제4권4호
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• pp.147-154
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• 2012

The purpose of this study is to examine the effect of voice improvement when vocal training, which relaxes the vocal contact, is applied to children with vocal nodules. Subjects included 20 5- to 12-year-old boys with vocal nodules in Otolaryngology and for whom voice therapy had been advised. The vocal therapy was conducted for 40 minutes per a week for a total of eight times. Results were evaluated by videostroboscopy, auditory-perceptual evaluation of GRBAS Scale, aerodynamic test, and acoustic analysis before and after therapy. As a result, first, the size of vocal nodules was reduced and the unstable pattern of vocal contact was improved. Glottic closure was increased and Phase symmetry was decreased during vocal vibration. Mucosal wave was increased and muscle tension of the larynx was reduced. Second, auditory-perceptual evaluation showed that subjects' overall quality of voice improved. GRBAS Scale Evaluation showed that the characteristics of the subjects' voice which were rough, breathy, and strained and breathy were reduced after therapy. Third, the measurements of acoustic parameters showed a statistically significant improvement. The fundamental frequency of the subejects' voice was increased and values of Jitter and Shimmer, NHR, [H1-H2] decreased. Fourth, the maximum phonation time of children was increased. These results imply that vocal relaxation training conducted in this study has a very positive effect to improve the voice of children with vocal nodules.

• 대한후두음성언어의학회지
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• 제21권1호
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• pp.32-36
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• 2010

Background : Vocal fold injection using autologous material (fat or collagen) is very useful. However, Autologous material have variable resorption times and results, Plasma gel is a new injection material. The purpose of this study is to introduce a new injection material and discuss the effectiveness and complications. Subjects and Method: Eleven cases with vocal cord paralysis were analyzed after plasma gel injection, The plasma gel was acquired from patient's own blood. The preoperative and postoperative parameters including maximum phonation time (MPT) and subject aspiration score were analyzed. Results: There was a significant improvement in MPT and aspiration score in the case of vocal cord palsy. There was only one laryngeal complication. Conclusion : According to these preliminary results, the injection laryngoplasty with Plasma gel is a simple, safe, cheap procedure for temporally vocal fold palsy.

• 음성과학
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• 제4권2호
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• pp.115-139
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• 1998

The aim of this study is to develop an the assessment program for the singing voice which is based on the physiological and acoustic methods. 22 sopranos, 6 mezzo sopranos, 4 tenors and 4 baritones participated to these experiments. The results measured by Visi-Pitch, spectrograph, and strobo-scope can be summarized as follows: (1) The maximum phonation time of singers must over 14 second higher with one deep inspiration (2) The parts classified by vocal range using Visi-Pitch: soprano between 167Hz $\sim$1,190Hz, mezzo soprano between 146Hz$\sim$956Hz, tenor between 75Hz$\sim$503Hz and baritone between 73 Hz and 385 Hz. (3) Longitudinal glottal size of singers decreases depending on the high-low pitch variation while lattitudinal glottal size increases depending on high-low pitch variation. (4) Well-trained singers show over 5 times the vibrato rate of untrained singers and regular pitch variation during measured periods. Vibrato's intensity do not over 3 dB. (5) Singer's formant indicates professional voice depending on the each parts: 3,207 Hz for soprano, 3,057 Hz for mezzo soprano, 2,754 Hz for tenor and 2,560 Hz for baritone.. (6) $F_1$ of singing voice is higher than that of speech while $F_2\;and\;F_3$ of singing voice are lower than those of speech.

• 음성과학
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• 제13권3호
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• pp.133-149
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• 2006

This study attempted to compare acoustic parameters, physiological observation and perceptual evaluation values obtained from the treatment and control groups in order to find out which of the self voice feedback therapies was better and which methods to train them were more effective. The experimental group carried out various self voice feedback therapies while the control group did only vocal hygiene. The acoustic measurement and voice manipulation for providing the patients visual, auditory feedback were done by a speech analysis software, Praat. The authors designed vocal hygiene, abdominal respiration and Praat self voice feedback therapies and applied them to 15 patients while applying only one vocal hygiene to 15 of the control group. For the purpose of examining the degree of their voice improvement after the treatment, pre- mid- and final evaluations were made for the two groups at the beginning, the 6th week and immediately after the 8th treatment session. Results of this study were as follows: The treatment group showed much improvement after receiving the voice treatment. In particular, acoustical and physiological indices from the optical endoscopy, pitch variation(Jitter), amplitude variation (Shimmer), maximum phonation time(MPT), and psychoacoustic evaluation showed statistically significant improvements over the control groups.