• Title/Summary/Keyword: Phonation Efficiency

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Comparison of the Voice and Treatment Results after Laser Cordectomy or Radiotherapy on Tla Staged Glottic Cancer (Tla 병기의 성문암에 대한 레이저 절제술과 방사선 치료 비교)

  • 남순열;이윤세;김찬종;김종찬;김범규;김상윤
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.139-144
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    • 2002
  • Background and objectives : The various voice-conserving treatments are used for Tla staged glottic cancer. Especially, Tla staged glottic cancer has been shown excellent treatment result after laser cordectomy or radiotherapy. To evaluate which treatment results better voice after treatment made it valuable to define the exact indication and recommending treatment modality on the Tla staged glottic cancer patients. Method : The medical records of 75 patients with glottic TlaN0 cancer diagnosed at Asan medical center, University of Ulsan college of medicine form May, 1989 to July,2001 were retrospectively reviewed on the point of voice quality and oncology including 5-year survival rate and local control rate. Results : Laser cordectomy and radiotherapy showed 100% and 94.0% 5-year survival rate, respectively. And laser cordectomy had 94.3% local control rate while radiotherapy got 87.6% local control rate. Voice analysis of pretreatment and posttreatment were used to compare each result. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum confortable phonation time(MPT) and vocal efficiency(VE) were used for parameters for voice analysis. Only in shimmer and MPT, we could find significant posttreatment difference between two therapies. In addition, we reviewed the total expenses for each therapy. Conclusion : On the basis of the oncologic result, both the laser cordectomy and radiotherapy had the similar results. Laser cordectomy showed the relatively acceptable voice as radiotherapy did. Laser cordectomy cost less than radiotherapy did. Laser cordectomy can be used for treatment about Tla staged glottic cancer.

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Analysis of Phonatory Aerodynamic & E.G.G. during Passaggio of the Trained Male Singers (남성성악가의 Vocal Register Transition(Passaggio)시 공기역학적 변화와 EGG의 변화 연구)

  • Nam, Do-Hyun;Choi, Seong-Hee;Choi, Jae-Nam;Choi, Hong-Shik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.15 no.1
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    • pp.21-26
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    • 2004
  • Vocal Register Transition(Passaggio) is one of the most important vocal technique for classically trined male singers(tenor). Passaggio is that it bridges the chest register to head register without a noticeable voice break. Vocalist gest the feeling that voice is not locked a particular register. The purpose of this study was to clarify the difference between easy($B_3$) tone and non passaggio(F#_4$) & passaggio(F#_4$). We selected 6 trained singers(tenor), who had more than 12.6 years of experience and were well trained in passaggio technique. Simulataneous measurement was performed frequency(F0), mean flow rate(MFR), intensity(I), and subglottal pressure(Psub) using a phonatory function analyzer(Nagashima) and Closed Quotient(CQ), Jitter, Shimmer, NHR a Electro-glottography(EGG) of Lx. Speech Studio(Laryngogrph Lt, London, UK) and vocal efficiency was calculated by Carroll's method. For the tenor, target tone/a/was measured in three conditions : 1) easy phonation : $B_3$, 2) high tone without passaggio : F#_4$, 3) high tone with passaggio : F#_4$). The results revealed that F0 of the target tones between non-passaggio group and passaggio group were not significantly different though higher is F0, higher is subglottal pressure. And also CQ, MFR, Psub were increased in passagio than nonpssagio but these values were not statistically different. This study concluded that passaggio is the vocal technique to make the same quality of tone between chest register and head register in tenor.

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The Comparison of the Acoustic and Aerodynamic Characteristics of $PROVOX^{(R)}$ Voice and Esophageal Voice Produced by the Same Laryngectomee (동일 후적자가 산출하는 기관식도 발성($PROVOX^{(R)}$ 발성)과 식도 발성에 대한 음향학적 및 공기역학적 특성 비교)

  • Pyo, H.Y.;Choi, H.S.;Lim, S.E.;Choi, S.H.
    • Speech Sciences
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    • v.5 no.1
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    • pp.121-139
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    • 1999
  • Our experimental subject was a laryngectomee who had undergone total laryngectomy with $PROVOX^{(R)}$ insertion, and learned esophageal speech after the surgery, so he could produce both $PROVOX^{(R)}$ voice and esophageal voice. With this subject's production of $PROVOX^{(R)}$ and esophageal voice, we are to compare the acoustic and aerodynamic characteristics of the two voices, under the same physical conditions of the same person. As a result, the fundamental frequency of esophageal voice was 137.2 Hz, and that of $PROVOX^{(R)}$ was 97.5 Hz. $PROVOX^{(R)}$ voice showed lower jitter, shimmer and NHR than esophageal voice, which means that $PROVOX^{(R)}$ voice showed better voice quality than esophageal voice. In spectrographic analysis, the formation of formants and pseudoformants were more distinct in esophageal voice and several temporal aspects of acoutic features such as VOT and closure duration were more similar with normal voice in $PROVOX^{(R)}$ voice. During the sentence utterance, esophageal voice showed longer pause or silence duration than $PROVOX^{(R)}$ voice. Maximum phonation time and mean flow rate of $PROVOX^{(R)}$ voice were much longer and larger than esophageal voice, but mean and range of sound pressure level, subglottic pressure and voice efficiency were similar in the two voices. Glottal resistance of esophageal voice was much larger than $PROVOX^{(R)}$ voice which showed still larger glottal resistance than normal voice.

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Full mouth rehabilitation of mandibular edentulous patient using implant hybrid prosthesis (하악 무치악 환자에서 임플란트 하이브리드 보철물을 이용한 전악 수복 증례)

  • Kim, Seong-Bin;Kim, Sung-Hoi;Park, Young-Bum;Moon, Hong-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.3
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    • pp.214-220
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    • 2013
  • Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported- overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

Quantitative Analysis of Voice Quality after Radiation Therapy for Stage T1a Glottic Carcinoma (T1a 병기 성문암의 방사선 치료 후 음성에 관한 연구)

  • Lee Joon-Kyoo;Chung Woong-Gi
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.17-21
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    • 2005
  • Purpose : To evaluate the voices of irradiated patients with early glottic carcinoma and to compare these with the voices of healthy volunteers. Materials and Methods : The voice samples (sustained vowel) of seventeen male patients who had been irradiated for T1a glottic squamous carcinoma at least 1 year prior to the study were analyzed with objective voice analyzer (acoustic voice analysis, aerodynamic test, and videostroboscopic analysis) and compared with those of a normal group of twenty age- and sex-matched volunteers. Average fundamental frequency, jitter, shimmer, and noise-to-harmonic ratio were obtained for acoustic voice analysis. Maximal phonation time, mean flow rate, intensity, subglottic pressure, glottal resistance, glottal efficiency, and glottal power were obtained for aerodynamic test. Results : The irradiated group presented higher values of shimmer in acoustic voice analysis. There was no significant difference between two groups in other parameters. Conclusion : In this study all the objective voice parameters except shimmer were no4 significantly different between the irradiated group and the control group. These results suggest that the voice quality is minimally affected by radiation therapy for 71 a glottic carcinoma.

Comparison of mean airflow rate before and after treatment in patients with sulcus vocalis according to aerodynamic analysis methods (성대구증 환자의 공기역학적 검사 방법에 따른 치료 전과 후의 평균호기류율 비교)

  • Seung Yeon Lee;Hong-Shik Choi;Jaeock Kim
    • Phonetics and Speech Sciences
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    • v.15 no.4
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    • pp.61-69
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    • 2023
  • Sulcus vocalis is characterized by incomplete closure of the vocal folds, with a high mean airflow rate (MFR) as a distinctive feature. The MFR is measured using two aerodynamic analysis methods [the maximum sustained phonation protocol (MXPH) and voicing efficiency protocol (VOEF)] of the phonatory aerodynamic system (PAS), and the results may vary depending on the method. This study compared the differences in MFR before and after treatment (microsurgery and voice therapy) according to the MXPH and VOEF of the PAS in 30 patients with sulcus vocalis. Additionally, we examined whether there were differences in the subjective voice evaluation (voice handicap index, VHI), perceptual voice evaluation (GRBS), and fundamental frequency (F0) before and after treatment. The results showed significant differences between the two methods, both before and after treatment, in patients with sulcus vocalis. However, there were no significant differences by methods in the changes before and after treatment. The VHI and GRBS scores significantly decreased after treatment; however, F0 showed no significant differences before and after treatment. This study indicates that when evaluating MFR changes in patients with sulcus vocalis, it is acceptable to use either aerodynamic analysis (MXPH or VOEF).

Effects of vocal aerobic treatment on voice improvement in patients with voice disorders (성대에어로빅치료법이 음성장애환자의 음성개선에 미치는 효과)

  • Park, Jun-Hee;Yoo, Jae-Yeon;Lee, Ha-Na
    • Phonetics and Speech Sciences
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    • v.11 no.3
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    • pp.69-76
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    • 2019
  • This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.