• 말소리와 음성과학
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• 제5권1호
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• pp.55-62
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• 2013

This study compared the aerodynamic multiparameters of whispers and phonation in patients with muscle misuse dysphonia(MMD) to evaluate the voice aerodynamic analysis for discrimination between whispers and phonation. Eleven patients with muscle misuse dysphonia were examined. Whispers were shorter with a maximum phonation time(MPT; p<.01), a lower phonatory sound pressure level(SPLp; p<.01), a higher phonatory flow rate (PFR; p<01), lower phonatory efficiency(PE; p<.01), and a lower phonatory resistance (PR; p<.05) than phonation. The subglottal pressure level was not significantly different between whispers and phonation. (Psub; p>.05). The ROC analysis showed that the threshold of 23.83 ppm for PE achieved a good classification for whispers, with the perfect sensitivity(100%) and specificity(100%). Those results indicate PE reliably distinguished between whispers and phonation. The results also suggest that PE may provide a useful tool for studying the laryngeal source.

• 말소리와 음성과학
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• 제5권1호
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• pp.63-69
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• 2013

This study attempted to investigate the characteristics of Phonation Threshold Pressure and Phonation Threshold Airflow of Patients who have Functional voice disorder. 50 subjects participated in study (32 subjects were patients who had functional voice disorders and 20 subjects were normal adults). The PAS (Phonatory aerodynamic system, model 6600, KAY electronics, Inc.) was used to measure the data and to do the analysis. Data from the Phonation Threshold Pressure was measured using voicing efficiency of the PAS protocol. Data from the Phonation Threshold Airflow was measured using Maximum Sustained Phonation of the PAS protocol. Those were used because of the ease of phonation. The results of this study showed that the differences in Phonation Threshold Pressure and Phonation Threshold Airflow between patients who had functional voice disorder and normal adults could be significant index. Patients who had functional voice disorder showed more higher figures than normal adults. These results suggest that Phonation Threshold Pressure and Phonation Threshold Airflow are very useful in diagnosing the voice disorder. The measured data also provided useful information for diagnosing patients with vocal fold diseases.

• 말소리와 음성과학
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• 제8권3호
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• pp.39-49
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• 2016

The present study examined the change of aerodynamic features after laryngomicrosurgery in patients with vocal polyps. Aerodynamic evaluation was performed in thirty-nine patients (15 males and 24 females) one week before surgery and four weeks after surgery. Evaluation protocols of vital capacity, maximum sustained phonation(MXPH), and voicing efficiency(VOFT) were used to collect 29 phonatory aerodynamic measures, requiring voice with a comfortable pitch and loudness. Statistically significant changes were found for phonation time and airflow values in the MXPH protocol, while changes were also found for airflow values, subglottal pressure values and acoustic resistance values in the VOFT protocol. Although phonation time was increased in both male and female patients, gender-dependent changes were found in airflow measurements. Men's phonation time increased with no difference in airflow rate, but women's phonation time increased with decreased airflow rate and lower subglottal pressure. The changes of aerodynamic features may be affected by women's self-perceived change for vocal attitude, which was reducing sense of vocal effort after surgery.

• 대한후두음성언어의학회지
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• 제12권2호
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• pp.121-125
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• 2001

Singing requires exquisite coordination between the respiratory and phonatory system to efficiently control glottal airflow. Respiratory function and vocal aerodynamics were investigated in six female professional sopranos and in six female subjects without vocal training. All sopranos had more than 15 years of formal classic vocal training. Pulmonary function test data on simple pulmonary function, flow volume curve, static lung volumes, maximum inspiratory pressure(MIP), and maximum expiratory pressure(MEP) were obtained from all subjects. Vocal aerodynamic studies of maximum phonation time(MPT), phonation quotient, and mean glottal flow rates (MFR) were also measured in all subjects. Simple pulmonary function in professional sopranos was generally the same as that of other female subjects without vocal training. However, MIP and MEP showing respiratory muscle forces were significantly elevated in professional sopranos, compared to those of other female subjects without vocal training. Maximum phonation times and phonation quotient in sopranos are longer than those of other female subjects even though there were no differences in simple pulmonary function. High-pitched tones were made with significantly higher mean glottal flow rates(GFR) in normal subjects than low-pitched tones, whereas no changes in GFR were found in sopranos. The result indicated that sopranos demonstrated significant improvements in aerodynamic measures of GFR, maximum phonation time, suggesting an increase in glottal efficiency.

• 말소리와 음성과학
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• 제4권2호
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• pp.95-104
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• 2012

Thyroidectomy patients may have vocal paralysis or paresis, resulting in a breathy voice. The aim of this study was to investigate the aerodynamic and acoustic characteristics of a breathy voice in thyroidectomy patients. Thirty-five subjects who have vocal paralysis after thyroidectomy participated in this study. According to perceptual judgements by three speech pathologists and one phonetic scholar, subjects were divided into two groups: breathy voice group (n = 21) and non-breathy voice group (n = 14). Aerodynamic analysis was conducted by three tasks (Voicing Efficiency, Maximum Sustained Phonation, Vital Capacity) and acoustic analysis was measured during Maximum Sustained Phonation task. The breathy voice group had significantly higher subglottal pressure and more pathological voice characteristics than the non breathy voice group. Showing 94.1% classification accuracy in result logistic regression of aerodynamic analysis, the predictor parameters for breathiness were maximum sound pressure level, sound pressure level range, phonation time of Maximum Sustained Phonation task and Pitch range, peak air pressure, and mean peak air pressure of Voicing Efficiency task. Classification accuracy of acoustic logistic regression was 88.6%, and five frequency perturbation parameters were shown as predictors. Vocal paralysis creates air turbulence at the glottis. It fluctuates frequency-related parameters and increases aspiration in high frequency areas. These changes determine perceptual breathiness.

• 말소리와 음성과학
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• 제6권4호
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• pp.195-203
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• 2014

The aim of this study was to investigate the effects of phonation types ([+/- aspirated], [+/- fortis]) on aerodynamic measures with Korean bilabial stops. Sixty-three healthy young adults (30 males, 33 females) participated to evaluate the VOEF (Voicing Efficiency) tasks with bilabial stop consonants /$p^h$/, /p/, /p'/ using Phonatory Aerodynamic System (PAS) Model 6600 (Kay PENTAX Corp, Lincoln Park, NJ). All VOEF measures were significantly influenced by phonation types except RANP(pitch range)(p <.01). For sound pressure, maximum SPL, mean SPL, and Mean SPL during Voicing have been shown to be significantly greatest in fortis stop /p'/ than aspirated /$p^h$/ and lenis stop /p/ (p<.001). On the other hand, mean pitch after lenis stop was significantly lower than after aspirated and fortis stops (p<.001). Peak expiratory airflow, Target airflow, and FVC (Expiratory volume) were significantly lowest in fortis stop /p'/ which might be associated with higher aerodynamic resistance while peak air pressure and mean peak air pressure during closure were significantly lower in lenis stop /p/. Additionally, AEFF (Aerodynamic efficiency) was significantly higher in fortis stop /p'/ than lenis stop /p/ as well as aspirated stop /$p^h$/ (p<.001). Thus, sound pressure, airflow parameters, and aerodynamic resistance made crucial roles in distinguishing fortis /p'/ from lenis stop /p/ and aspirated. Additionally, pitch and subglottal air pressure parameters were important aerodynamic characteristics in distinguishing lenis /p/ from fortis /p'/ and aspirated /$p^h$/. Therefore, accurate aspirated /p/ stop consonant should be elicited when collecting the airflow, intraoral pressure related data with patients with voice disorders in order to enhance the reliability and relevance or validity of aerodynamic measures using PAS.

• 말소리와 음성과학
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• 제6권1호
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• pp.105-117
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• 2014

The purpose of this study was to (1) establish a Korean adult normative database for phonatory aerodynamic measures obtained with the KayPENTAX Phonatory Aerodynamic System (PAS) Model 6600, (2) investigate the intra-subject reliability of these measures across three testing sessions, and (3) examine the effect of gender on those measures. 170 healthy normal speakers (70 men and 100 women) between the ages 18 and 49 years participated in the study. The PAS protocol of maximum phonation and voicing efficiency were conducted and 25 measures were obtained. All aerodynamic measures taken in this study demonstrated high intra-subject reliability in clinical aspect. There were no significant effect of gender in the measures related to sound pressure and subglottal pressure. However, significant differences for gender were found for phonation time, airflow rate, expiratory volume, aerodynamic power, SPL range, pitch range, mean pitch, aerodynamic resistance, and aerodynamic efficiency. Clinicians should be aware of significant gender effects in some aerodynamic parameters when interpreting the data obtained from PAS.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.85-88
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• 2008

Several parameters are used for the assessment of phonatory function and voice quality in clinical settings. Glottic airflow, subglottal pressure, mean phonation time, laryngeal resistance and voice efficiency are the most commonly used aerodynamic parameters. Aerodynamic analysis is developed to evaluate phonatory energy source and to estimate laryngeal efficiency. Also these measurements have shown the good correlation with perceptions of breathiness and findings of glottic competence. Aerodynamic study is important to understand relationships between pulmonary and phonatory function.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.98-103
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• 2000

Background and Objectives : The etiology and pathophysiology of spasmodic dysphonia is yet unknown. This study was performed to determine if any laryngeal aerodynamic parameter distinguish the voice of patient diagnosed as having adductor spasmodic dysphonia from individuals with normal voice production and to investigate the pathophysiology of spasmodic dysphonia. Materials and Methods : fifteen women diagnosed as having adductor spasmodic dysphonia and fifteen normal control women participitated in this study Maximum phonation time, mean air flow rate, subglottic pressure, vocal efficiency, Vfo, NHR, VTI, FTRI, ATRI, Jitter percent, Shimmer percent were obtained from the participants using 'MDVP(multi-dimensional voice program)' of CSL(Computerized Speech lab, Kay Elemetrics, Co., Model No. 4300), and 'maximum sustained phonation' and 'IPIPI test' of AP II(Aerophone II, Kay Elemetrics, Co., Model 6800). Results : T-test statistical analysis revealed statistically different values for vocal efficiency, Vfo, NHR, MPT, litter percent, Shimmer percent between the spasmodic dysphonia group and the control group. Conclusions : Spasmodic dysphonia affects the ability of the laryngeal mechanism to function effectively. Results from our study demonstrate that certain aerodynamic and acoustic parameters distinguish adductor spasmodic dysphonia from normal voice.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.71-75
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• 2012

Recurrent laryngeal nerve paralysis is the most common and serious complication after thyroid cancer surgery. The objective of this study was to report the advantages of the vein wrapping technique for nerve reconstruction in patients with thyroid cancer invading the recurrent laryngeal nerve and its effects on postoperative phonatory function. The subjects were three patients who underwent resection of the recurrent laryngeal nerve during surgical extirpation of papillary thyroid cancer. Free ansa cervicalis nerve graft or direct neurorrhaphy with a vein wrapping technique was used to facilitate nerve regeneration, protect the anastomosed nerve site mechanically, and prevent neuroma formation. One-year postoperative laryngoscopic examination revealed good vocal cord mobility. Maximum phonation time ($19.5{\pm}0.3$ sec) was longer than a previously-reported value in conventional reconstruction patients ($18.8{\pm}6.6$ sec). The present phonation efficiency index ($7.88{\pm}0.78$) was higher than that previously calculated in conventional reconstruction ($7.59{\pm}2.82$). The mean value of the Voice Handicap Index-10 was 6, which was within the normal range. This study demonstrates improvement in phonation indices measured 1 year after recurrent laryngeal nerve reconstruction. Our results confirm that the vein wrapping technique has theoretical advantages and could be favored over conventional reconstruction techniques for invenerate nerve injuries.