• 말소리와 음성과학
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• 제3권2호
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• pp.99-105
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• 2011

The treatment for patients with mutational dysphonia typically is useful with vegetative phonation, but has not yet been studied. This study attempts to identify the effect of $SKTCLP^{(R)}$ using throat clearing and laughing in patients with mutational dysphonia. The study, which was designed by the author, included 26 patients aged from 14 to 32 years (mean: 18.7 years) who had been diagnosed with mutational dysphonia between January 2007 and June 2010. Voice therapy for these patients included $SKTCLP^{(R)}$, ranging from two to seven sessions (mean: 3.8 sessions). Results were evaluated by videostroboscopy, perceptual evaluation of GRBAS scale, aerodynamic test, and acoustic analysis before and after therapy. Most patients could phonate with low pitch from the beginning and sustain with normal pitch sound in the last session. We had found that glottic gap reduced after therapy and anterior-posterior compression of superior laryngeal part at the first time, and these patients had complete closure of the glottis after treatment. The results of acoustic and aerodynamic measures after treatment indicated significant decreases in Fo, Jitter, Shimmer, SFF, and SPI, and increases in MPT, Psub, and vocal efficiency (p<.05). $SKTCLP^{(R)}$ may be a useful treatment method in managing mutational dysphonia. We can suggest this technique may be useful in improving the voice quality of other functional dysphonia having glottal chink or functional aphonia.

• 음성과학
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• 제3권
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• pp.5-17
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• 1998

Botulinum toxin, a neurotoxin derived from Clostridia Botulinum, has been injected into the target muscle(s) for the treatment of several kinds of voice and speech disorders at the Voice Clinic, Yonsei Institute of Logopedics and Phoniatrics since December 1995. Criteria for the diagnosis and method of injection for spasmodic dysphonia, mutational dysphonia, muscle tension dysphonia, dysphonia after total laryngectomy, and stuttering were summarized. Among 144 patients with adductor type spasmodic dysphonia, who were injected one time to maximum 8 times during the 27 months, 90% were recognized as having better than slight improvement. Even though the injected cases were small, not only the abductor type spasmodic dysphonia, but also the intractable mutational dysphonia or muscle tension dysphonia resistant to voice therapy revealed that botulinum toxin injection would be another options for treatment. Patients who cannot phonate after total laryngectomy and some forms of adulthood stutterers can also be candidates for the injection of botulinum toxin.

• 대한후두음성언어의학회지
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• 제6권1호
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• pp.43-45
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• 1995

Type III thyroplasty is a useful surgical procedure reducing the tension of vocal cords by removing the vertical strip of anterior thyroid cartilage and resuturing the cut ends. One of the indications for this procedure is mutational dysphonia, the disease of men who has a childlike vocal pattern even after the process of puberty. We have experienced one case of mutational dysphonia treated with type III thyroplasty. He had high pitched voice from the middle school age and his preoperative fundamental frequency was 272.35 Hz. Two months after the surgery. the fundamental frequency was 129.58 Hz and the patient was also subjectively satisfied with his low-toned voice.

• 대한후두음성언어의학회지
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• 제7권1호
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• pp.61-68
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• 1996

Failure to change from the higher pitched voice of preadolescence to the lower pitched voice of adolescence and adulthood is called "mutational dysphonia" The voice is weak, thin, breathy, hoarse, and mono-pitched. If the voice theraphy was failed, surgery to lower vocal pitch which is refered to thyroplasty type III, is indicated. We compared the post-op acoustic parameters with pre-op data in unilateral antero-posterior shortening of the thyroid cartilage method and bilateral antero-posterior shortening of the thyroid cartilage method each other. Bilateral antero-posterior shortening of the thyroid cartilage method shows significant drop of fundamental frequency and speaking fundamental frequency statistically than unilateral shortening method. There was no significant differences in Jitter, Shimmer, SNR, MFR and other psychoacoustic analysiss parameters between two groups. These data shows that unequal tension of the vocal cord in uilateral antero-posterior shortening of the thyroid cartilage method does not control the pitch effectively so bilatreal shortening method in Type III thyroplasty is recommandable procedure in surgery of the mutational dysphonia.

• 대한후두음성언어의학회지
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• 제25권2호
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• pp.82-85
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• 2014

Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

• 대한후두음성언어의학회지
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• 제10권1호
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• pp.17-23
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• 1999

Vocal hyperfunction is considered to be the most significant characteristic in larynx disorders which is found among many patients presenting hoarseness Primarily as chief complaint. In Pusan National University Hospital, we executed the voice therapy to 28 patients being 17 female and 11 male patients who visited the Voice ＆ Speech Therapy Clinic, due to the voice disorder, and then compared and analysed the voice before and after its therapy using acoustic and aerodynamic test. The obtained results were as follows. In the analysis by the local findings, it was improved to 88% in the patients of vocal nodule, 75% in mutational falsetto, 75% in the functional dysphonia, 75% in the vocal cord palsy, 50% in the vocal polyp and 50% in dysphonia plica ventricularis. For the acoustic analysis, Fo, litter, Shimmer and NHR were measured. In the patients of mutational falsetto, Fo, Jitter and NHR were shown to be improved significantly and in the patients of vocal nodule, Shimmer was shown to be improved significantly. In the patients of vocal polyp, Fo was significantly improved. In the patients of vocal cord palsy in litter and NHH were significantly improved. In the patients of dysphonia plica ventricularis, Shimmer and NHR were significantly improved and the patients of functional dysphonia were more improved in Fo, litter and Shimmer. For the aerodynamic analysis, MPT was measured. In particular, it was shown to be improved significantly in the patients of vocal nodule, improved in the vocal polyp, vocal cord palsy, functional dysphonia patients.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.47-51
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• 2004

Normally, as a result of increased laryngeal growth, the male voice drops about one octave in pitch level during adolescence. Failure of the voice to drop in pitch is consider to be a clinically significant voice disorder - 'mutational dysphonia'. The aim of this article is to evaluate the changes brought about by voice therapy, using the analysis of the EGG measure from Lx Speech Studio program(Laryngograph Ltd, UK) as well as acoustic, and aerodynamic studies in 18-year-old mutational dysphonia patient. The results from the Lx Speech Studio program demonstrated bimodal distribution of DFx(Hz), DQx(%), QxFx and diplophonic characteristic. After voice therapy combined with manual compression method, the distribution of DFx, DQx, QxFx was changed uniform with a dramatic reduction of higher pitch level. In addition, this finding suggests the EGG measure helps to choice treatment options, monitor the efficacy of therapy, and estimate the prognosis of diseases.

• 대한후두음성언어의학회지
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• 제21권1호
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• pp.17-21
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• 2010

Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1994년도 제2회 학술대회 연제순서 및 초록집
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• pp.90-90
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• 1994

변성발성장애(Mutational dysphonia)는 원인이 확실히 밝혀져 있지는 않지만, 변성기에 성호르몬의 작용에 의한 정상적인 후두의 발육이 제대로 이루어지지 않아서 발생되는 것으로 추정되고 있다. 임상 양상은 대개 성인 남자임에도 불구하고 병적으로 음성의 기본주파수(fundamental frequency)가 높아서 여자 목소리에 가깝게 들린다는 것을 주 증상으로 하고 있으며, 이학적 검사상 성대의 움직임은 정상이나, 성대의 두께가 얇거나, 성대의 길이가 짧고 긴장도가 증가되어 있는 것 같이 보인다. 음성치료를 시도해 볼 수 있으며, Isshiki가 제 3형 갑상연골성형술로 효과적으로 치료될 수 있다고 보고한 이래, 다수의 보고자들에 의해 시도되어 왔다. (중략)

• 대한후두음성언어의학회지
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• 제5권1호
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• pp.69-74
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• 1994

Thyroplasty type III provides an effective mean of shortening the vocal fold. It is used primarily fer lowering vocal pitch. The indications for this surgery are the male patients with too high a vocal pitch of long duration which has proven resistant to voice therapy and a type of dysphonia characterized by high pitch and a breathy voice, in which the laryngeal findings include a very narrow glottal chink and a small amplitude of vibration, suggesting a stiff vocal cord. In this study, we have experienced two cases of high pitched voice, one is mutational falsetto and other is high pitched, breathy voice with stiff vocal fold. The results were satisfactorily successful with type III thyroplasty. So we report the cases of type III thyroplasty in patients of dysphonia with high pitched voice.