• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.48-52
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• 2019

Background and Objectives : Functional aphonia is characterized by incomplete closure of the vocal folds. Semi-occluded vocal tract exercise (SOVTE) allows smoothly vocal folds collision without damage to the vocal folds tissues to produce normal vocal intensity. The purpose of this study is to report the effect of SOVTE in patients with functional aphonia. Materials and Method : Seven patients diagnosed with functional aphonia were treated with 1-3 voice therapy sessions using voiced lip-trill, humming, Lax Vox in SOVTE. To assess the effectiveness of semi-occluded vocal tract exercise, cepstral analysis and auditory perceptual assessment were performed before and after voice therapy. Results : F0 (fundamental frequency), CPP (cepstral peak prominence) and L/H ratio (low/high spectral ratio) were significantly increased, while CPP Standard deviation, L/H ratio Standard deviation were decreased. In addition, 'Grade', 'Breathiness' and 'Asthenia' were significantly decreased in the GRBAS scale after SOVTE (p<0.05). Conclusion : In our study, SOVTE seemed to be effective to elicit voice quickly and promote vocal folds vibration without muscular effort in patients with functional aphonia.

• Phonetics and Speech Sciences
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• v.13 no.4
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• pp.67-74
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• 2021

This study examines the effectiveness of semi-occluded vocal tract exercise (SOVTE) conducted through telepractice for 10 female teachers who have experienced vocal discomfort while working in early childhood education facilities (childcare centers, kindergartens). The effects of SOVTE conducted through telepractice were evaluated based on the Korean voice handicap index (KVHI), the Korean version of the voice activity and participation profile (K-VAPP), vocal effort, and auditory perception evaluation by using the grade, roughness, breathiness, asthenia, and strain (GRBAS) scale. The results show that total, functional, and physical scores of KVHI significantly reduced after SOVTE. The total score in K-VAPP significantly reduced after SOVTE. Moreover, vocal effort significantly decreased after SOVTE. However, statistically significant differences were not noted in GRB scales before and after SOVTE. In conclusion, early childhood teachers experienced reduced vocal discomfort SOVTE conducted through telepractice. The study results indicate that voice therapy conducted through telepractice is an effective method for reducing vocal discomfort in early childhood teachers.

• Phonetics and Speech Sciences
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• v.15 no.3
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• pp.53-58
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• 2023

After thyroidectomy, some patients who show normal vocal cord movement still complain of subjective voice problems, which could lead to a decrease in quality of life related to communication. This study aims to investigate the effectiveness of a newly designed voice therapy applying neck exercise and semi-occluded vocal tract exercise (SOVTE) to improve voice problems after thyroidectomy without neurological injury. For this purpose, voice therapy was randomly assigned to 10 women who received thyroidectomy. Acoustic analysis [fundamental frequency, jitter, shimmer, noise-to-harmonics ratio, min Voice Range Profile (VRP), max VRP, VRP] was performed before and after surgery and immediately after voice therapy to compare voice changes. The study showed a statistically significant increase in max VRP and VRP after voice therapy compared to before surgery. These results suggest that the voice therapy methods in this study effectively improve a major symptom of voice problems after thyroidectomy, specifically the reduction in the high-frequency range. However, this study was limited in the number of s participants and did not control for the type of surgery. Therefore, further research utilizing larger sample sizes and controlled variables is needed to investigate the long-term effects of voice therapy.

• Phonetics and Speech Sciences
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• v.8 no.2
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• pp.57-63
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• 2016

Recently, the Lax Vox voice therapy has been used as one of the SOVTE(Semi-Occluded Vocal Tracts Exercise). The purpose of this study was to explore the effect of Lax Vox voice therapy for a patient with Spasmodic dysphonia on voice improvement. One female spasmodic dysphonia patient(age=27) who had been diagnosed by a laryngologist received Lax Vox voice therapy. The Lax Vox protocol was configured as 5 steps (1 warm-up and 4 steps : bubbling without / with phonation/ gliding with phonation/ generalization) in this study. A total of 11 sessions were performed by a certified speech language pathologist. The present study evaluated the acoustic, aerodynamic, auditory perceptual, and patient's self-rating between pre-, mid-, and post- voice therapy. All objective and subjective parameters were improved after voice therapy; Reduced frequency variation, increased maximum phonation time, enlarged voice range, improved 'G' and 'S' in GRBAS & USDRS, and reduced VHI were observed. Especially, decreased $f_0$ and remarkably reduced voice tremor were also demonstrated following Lax Vox voice therapy. Accordingly, Lax Vox voice therapy technique can be useful for improving voice and quality of life in patients with spasmodic dysphonia.

• Phonetics and Speech Sciences
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• v.10 no.4
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• pp.135-146
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• 2018

The Modified Voiced Lip Trill (MVoLT) training is a variant of voiced lip-till training characterized by increased loudness, lowered laryngeal position, and lip contact facilitated with fingers. The purpose of the current study was to assess the effect of the MVoLT training program on vocal changes of musical singing theater students. A total of 32 musical theater students (17 males and 15 females, age ranging from 18 to 29) participated in the study. For about three months, each participant was tutored using a systematic program focussing on the MVoLT training, accompanied by certain facilitating strategies. Pre- & post-training multi-dimensional vocal characteristics were assesed and compared. Results showed that cepstral peak prominence during vowel phonation increased after training, while its standard deviation and Cepstral Spectral Index of Dysphonia decreased. When an aerodynamic assessment was performed, maximum phonation time, subglottal pressure, mean airflow rate increased, while electroglottographic measures did not change. In addition, decreased psychometric measures, higher maximum pitch, and increased vocal range were noted after training. In conclusion, the MVoLT was proven to have a potential as an effective and safe training method for musical theater singing.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.13-18
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• 2020

Background and Objective The purpose of this study is to report the effect of voice therapy using the voice reinforcement method (VRM) in patients with vocal nodules. It is one of the holistic voice therapy methods for improving vocal mechanisms. VRM includes not only direct and indirect voice therapy, but also trial therapy and self-practice. Composed of four stages: vocal hygiene education, relaxation, reinforcement, and generalization. Materials and Methods The subjects were 13 patients who were diagnosed with vocal nodules. Acoustic analysis, auditory perceptual assessment, K-VHI-10 and nodules size were compared before and after voice therapy. Voice therapy was conducted by speech-language pathologist and the mean number was 4.2. Results In acoustic analysis, Jitter, vF₀, vAm, Shimmer, NHR, and VTI were significantly decreased. F₀ was increased after voice therapy for women. 'Grade', 'Rough,' and 'Breathy' were significantly decreased in the GRBAS scale after voice therapy. In addition, K-VHI-10 and nodules size were significantly decreased. Conclusion VRM seems to be an effective voice therapy method in vocal nodules treatment. In VRM, especially, trial therapy is given motivation for vocal nodules treatments and self-practice has a continuous therapeutic effect in everyday life. VRM can be also applied to the voice therapy for other hyper-functional dysphonia.

• Phonetics and Speech Sciences
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• v.15 no.2
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• pp.31-40
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• 2023

Tube phonation in water has been widely used for voice training among semi-occluded vocal tract (SOVT) exercises in which the patient bubbles with phonation keeping the tube submerged in water. This study aims to investigate the effect of tube diameter and water depth on bubble height and maximum phonation time (MPT) for patients with hyperfunctional voice disorders. Seventeen patients with hyperfunctional voice disorders were asked to bubble with sustained /u/ at the different inner diameters of tube (5, 7, and 10 mm), water depth (4, 7, and 10 cm). A water resistance phonation biofeedback system using a water height sensor was used for recording bubble height and MPT. The bubble height was significantly changed by the tube diameter while MPT was significantly changed with the tube diameter and water depth. Although the wider tube presented significantly lower bubble height for a given depth, relatively consistent bubble height was maintained. Depending on the water depth, the bubble height did not significantly differ for a given tube diameter. In addtion, MPT significantly decreased with water depth and a wider tube led significantly shorter MPT. A water level-driven water resistance biofeedback system provided useful information on bubble characteristics and vocal fold vibration depending on tube diameter and water depth. It can be useful to monitor the breath support during water resistance phonation for patients with hyperfunctional voice disorders.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.107-114
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• 2017

The purpose of the current study was to compare selected acoustic and electroglottographic measures (closed quotient, pitch, and loudness) among vowel phonation, traditional voiced lip trill ($VLT_T$), modified voiced lip trill methods ($VLT_M$). A total of 21 participants without voice complaints produced 4-second long samples using each phonation method. Results indicated that mean closed quotient of $VLT_M$ was higher than that of vowel phonation and $VLT_T$, while its range and standard deviation measures were higher than those of vowel phonation. Mean, range, standard deviation, maximum of pitch measures of $VLT_M$ were higher than those of vowel phonation. Lastly, mean and maximum loudness of the $VLT_M$ were higher than $VLT_T$. In conclusion, the current data indicate the possibility to use the $VLT_M$ as a training method for singing or a strategy to facilitate generalization effect of voice therapy. Current results also reflect the necessity for further study pertaining to the long-term effect of the $VLT_M$ training method. Clinical implications are discussed.