• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1998년도 제10회 학술대회 심포지움
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• pp.210-210
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• 1998

Vocal fold vibration is essentially the propagation of a mucosal wave, starting from the lower surface of the vocal fold. The mucosal upheaval (MU), where the mucosal wave starts and propagates upward, appears only when the vocal fold vibrates. We investigated the location of the mucosal upheaval in response In variations in vocal fold tension. Vibrations were elicited under three conditions: during bilateral thyroarytenoid (TA) muscle contraction, without TA muscle contraction and during vocal fold lengthening. TA muscle contraction was obtained by direct electrical stimulation of the muscle. The vocal fold was lengthened by cricothyroid (omitted)

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.76-80
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• 2000

Tongue-tip trill is a sound made by the tongue tip making contract with the alveolar ridge and oscillating rapidly as sound is produced. It is an exercise used by many singers to warm up the voice and used as one of the methods of voice rehabilitation for patients who have the vocal folds scarred postoperatively and also who present with a variety of disorders, particularly hypofunction and presbyphonia. We intended to investigate the mucosal vibration of the true vocal folds on tongue-tip trill by electroglottography and to find e effective methods of tongue-tip trill. One adult male volunteer participated. Spectrography and electroglottography were checked repeatedly 15 times, more than 5 second in each times, at same pitch, in three conditions of phonation : sustained /a/ vowel, anterior trill in which tongue-tip vibrated at anterior portion of alveolar ridge just behind the anterior tooth, and posterior trill in which at palatal crest behind the transverse palatine fold We measured the first and second formant to determine indirectly the position of tongue and calculated speed quotient and the ratio of closing phase to closed phase. Speed quotients of posterior trill were higher than sustained /a/ vowel and anterior trill in 14 times. The ratio of closing phase to dosed phase of posterior trill were lower than the others in 14 times. Mucosa of true vocal folds is vibrated more effectively on posterior trill rather than sustained /a/ vowel and anterior trill. So, when tongue-tip trill is used as a method of voice rehabilitation, we suggest that posterior trill is better in producing effective mucosal vibration

• 대한후두음성언어의학회지
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• 제24권2호
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• pp.107-111
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• 2013

Objectives : We developed two-dimensional (2D) scanning videokyomography to evaluate the mucosal wave of whole vocal cords in real time to overcome the limit of preexisting stroboscopy and line scanning videokymography which could not evaluate it. Methods : We implemented a continuous light source with high brightness, a high-definition CMOS camera, and capture board for saving the data. We created the software program to analyze the image data from the system. The test of the functionality of the 2D scanning videokymography camera was performed in one of the authors (P.H.J 32 years old male). Vocal cord images were obtained during normal phonation and falsetto phonation. Images were obtained also during cough, diplophonia. Results : The system made it possible to measure objective parameters, including fundamental frequency, amplitude, regularity, mucosal wave, and phase difference, medial and lateral peak, opening versus closing duration related to vocal fold vibration. Simultaneously, it enabled analysis of the whole mucosal wave of the entire vocal fold in real time. 2D scanning videokymography was also effective for evaluating the dynamic status of the vocal fold when the subject phonated aperiodic voice. Conclusion : In conclusion, 2D scanning videokymography can support the analysis of the whole mucosal wave of the entire vocal cord with objective vocal parameters, overcoming the limitations of stroboscopy and previous line scanning videokymography techniques.

• 음성과학
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• 제7권1호
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• pp.89-96
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• 2000

Examination of the vibrations of the vocal fold is very important in patients with voice changes. The newly developed videokymography (VKG) takes images in real time and records irregular vibrations of the vocal fold. However, there are few data on VKG findings. We studied VKG to evaluate the vibratory characteristics of the vocal fold in benign vocal fold lesions. Unique vibratory patterns, blurred demarcation of the mucosal propagation, decreased margin amplitudes, asymmetry in phase or amplitude, and a level difference of the contact site were observed in each benign vocal-fold lesion. We conclude that each type of laryngeal lesion has specific characteristic which are revealed by VKG examination, these parameters can be quantified and used to objectively evaluate VKG findings. Based on these results, VKG can be used as a supplementary diagnostic tool.

• 대한후두음성언어의학회지
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• 제24권1호
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• pp.28-32
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• 2013

Because the human voice is produced through vibration of the vocal cords during the exhalation of airflow, it is important to observe the vibration pattern of the vocal cords in patients complaining of voice changes. However, it is not easy to observe the actual vibration pattern of the vocal cord because it vibrates so fast that it cannot be observed by the naked eye and it is located deep in the throat. Recently, with advances in instruments, including laryngoscopes and video camera systems, the vibration pattern of the vocal cords can now be observed. However, considering that present video camera systems can detect 30-60 images per second and the vocal cord vibrates at 100-200 and 200-300 times per second in men and women, respectively, it is not possible to record the whole mucosal wave of the vocal cord in real time. To overcome this limitation, a stroboscope, which converts fast movements of the vocal cord into slower images, has been developed. Since then, several instruments were developed to examine vocal vibration pattern. However, each instruments have advantages and disadvantages. Therefore, we should know about these things to apply them in patients with voice problem.

• 대한후두음성언어의학회지
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• 제18권1호
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• pp.26-32
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• 2007

Objective and Background: Laryngeal stroboscope is an useful equipment in evaluation of vocal cord vibration and in early detection of mucosal lesion including invasive cancer of the vocal cord. Recently Lee et al. (2006) developed portable stroboscope using voice as synchronization signal. It has been frequently impaired ability to synchronize the flashes even in normal female. Authors tried to investigate various methods including vibration pick-up, microphone, laryngeal microphone, and contact microphone for development of simple and accurate method like electroglottograph signal. The purpose of this study was to estimate wheher the vibration pick-up is available and is consistent with the signal of EGG. Subjects and Methods: Authors compared the signals between EGG and noncontact method such as voice, contact methods including vibration pick-up, laryngeal microphone, and contact microphone in normal twenty adults (male 10 and female 10). The number of peak in one cycle was compared with the number of the peak in EGG, and the percent of phase difference in the peak was compared with EGG Also, authors tried to investigate which site of vibration pick-up was most effective for synchronization of stobo flashes. Three site including anterior neck below the cricoid cartilage, thyroid ala, and suprahyoid region were analysed. Results: Among various methods for synchronization of strobo flashes, vibration pick-up was most effective method in peak detection. And anterior neck below cricoid cartilage was the most available site of the vibration pick-up. Conclusion: Authors suggest that vibration pick-up is most available and effective method for synchronization of strobo flashes.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.58-61
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• 2008

A 66-year-old woman described a 6-month history of hoarseness after upper respiratory infection. She was a house wife and referred from an outside clinic under a diagnosis of vocal fold nodules. Strobovideolaryngoscopy revealed bilateral vocal fold lesions, and decreased mucosal wave of both vocal folds. She was brought to the operating room for microsuspension laryngoscopy. Under general anesthesia, dual intracordal cysts on left vocal fold were completely resected with microflap technique. The lesion on the right vocal fold turned out to be a reactive fibrous mass, which was also resected. Dual intracordal cysts were confirmed histopathologically. The one was an epidermoid cyst lined with squamous epithelium, and the other was a mucus retention cyst lined with cuboidal epithelium. Postoperative voice was acceptable by the patient and the mucosal vibration has much improved after the surgery.

• 대한후두음성언어의학회지
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• 제21권1호
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• pp.13-16
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• 2010

Diagnosis of a patient with dysphonia begins with a thorough history and physical examination. Larynx can be visualized either indirectly or directly with a rigid or flexible laryngoscope. One notable limitation of simple indirect laryngoscopy is that the examination dose not yields a recordable and reproducible image of the larynx and vocal tract. And unaided human eye is unable to visualize the vibratory patterns of the true vocal cord during phonantion. When available, stroboscopy provides useful information regarding vocal told closure, vibration, and mucosal wave which is useful to decide between microsurgery, vocal reeducation or a combined treatment Even there are some limitations, recognition of the advantages and disadvantages of stroboscopy allows for optimal appreciation and stroboscopy remains an essential diagnostic tool in the assessment of dysphonia.

• 대한후두음성언어의학회지
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• 제20권1호
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• pp.57-62
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• 2009

Background and Objectives : There are few studies reported that specifically examine the laryngeal function in patients with profound hearing loss or deafness, This study was designed to examine videostroboscopic findings and phonetic characteristics in adult patients with prelingually deaf. Materials and Method: Sixteen patients (seven males, nine females) diagnosed as prelingually deaf aged from 19 to 54 years, and were compared with a 20 normal control group with no laryngeal pathology and normal hearing group, Videostroboscopic evaluations were rated by experienced judges on various parameters describing the structure and function of the laryngeal mechanism during comfortable pitch and loudness phonations. Acoustic analysis test were done, and a nasalance test performed to measure rabbit, baby, and mother passage. CSL were measured to determine the first and two formant frequencies of vowels /a/, /i/, /u/, Statistical analysis was done using Mann-Whitney U or Wilcoxon signed ranks test. Results: Videostroboscopic findings showed phase symmetry but significantly more occurrences decrement in the amplitude of vibration, mucosal wave, irregularity of the vibration and increased glottal gap size during the closed phase of phonation, In addition, group of prelingually deaf patients were observed to have significantly more occurrences of abnormal supraglottic activities during phonation. The percentage of shimmer in the group of prelingually deaf patients were higher than in the control group. Characteristics of vowels were lower of the second formant of the vowel /i/. Nasalance in prelingually deaf patients showed normal nasality for all passages, Conclusion: Prelingually deaf patients show stroboscopic abnormal findings without any mucosal lesion, suggesting that they have considerable functional voice disorder. We suggest that prelingually deaf adults should perform vocal training for normalized laryngeal function after cochlear implantation.

• 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.