• 대한후두음성언어의학회지
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• 제27권1호
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• pp.40-44
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• 2016

Background and Objectives : Surgery is considered the primary treatment for intracordal cyst. However, patients who had undergone surgery are still subject to recurrence and continued voice changes. Intracordal cysts naturally disappear in some patient population. Cyst does not always recur in patients who had received partial surgical removal, too. Contradicting results raises a question whether complete surgical removal of intracordal cyst is necessary and demonstrate need for better treatment. Herein, the author proposes novel surgical method technique intralaryngeal needle technique (INT), a technique using surgical needle for not only injection but also for aspiration and excision of cyst. This study aims to examine the potential of intralaryngeal needle technique in treating intracordal cysts. Materials and Methods : Surgical procedures were done on in-patients diagnosed with intracordal cyst. 23 patients received follow-up screening after the surgery for one year. Patients' subjective satisfaction levels, acoustic measures, aerodynamic measures, laryngeal stroboscopic results were compared before and after the treatment. Results : Overall patients were satisfied with novel surgical excision method. In terms of aerodynamic measures, maximum phonation time, mean air flow rate improved after the surgery. In terms of acoustic measures, Jitter, Shimmer, NHR, and voice pitch changes after the treatment showed statistically significant differences. Laryngeal stroboscopy results showed significant decreases in cyst sizes. Post-surgery patients had improved mucosal waves and amplitudes values. Conclusion : The results show the validity of intralaryngeal needle technique in reducing intracordal cyst size by excision, aspiration, and injection. The author believes this novel technique can be used as an alternative surgical method for intracordal cysts.

• 대한후두음성언어의학회지
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• 제27권1호
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• pp.45-50
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• 2016

Background and Objectives : This study aims to conduct post-voice therapy to patients with unilateral vocal fold paralysis for vocal improvement, motility recovery and analyze the results. Materials and Methods : Voice therapy was conducted to 13 patients who had shown response to voice therapy amongst 98 patients diagnosed with unilateral vocal fold paralysis. In order to be able compare before and after perceptual, acoustic and aerodynamic evaluations were conducted after voice therapy. Also, by using dysphagia checklist, we have verified whether if the patient had dysphagia prior to voice therapy. The therapy was conducted by improving the larynx movement and glottal contact, whilst removing hypertension of the supraglottic. Results : All 13 patients who underwent voice therapy had shown improvements that are statistically significant from 4 scales excluding the S scale from auditory perception evaluation (p<0.05), with enhanced glottal contact. In acoustic evaluation, Jitter, Shimmer and NHR had shown significant improvement after voice therapy. MPT was also notably improved among aerodynamical evaluation (p<0.001). All 11 patients had with dysphagia prior to voice therapy reported to have improved swallowing functions. Conclusion : Application of adequate voice therapy to patients with unilateral vocal fold paralysis, is an effective method that might be employed in the initial phase. Especially, the voice therapy proposed in this study is expected to be useful for patients in hypertension status due to secondary compensation after initial paralysis, since it focuses on improving vocal symptoms in a calm state with the supraglottis sufficiently relaxed. Also, the therapy is expected to be effective for improving swallowing functions.

• 음성과학
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• 제10권2호
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• pp.111-128
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• 2003

Aerodynamic study is valuable information about the vocal efficiency in translating airflow to acoustic signal. The purpose of this study was to investigate the differences between trained singers and untrained controls under different two pitch by simultaneous using the airway interruption method and electroglottography (EGG). Under singing a Korean lied 'Gene', 20 (Male 10, Female 10) trained singers were studied on two one-octave different tone. Mean flow rate (MFR) , subglottic pressure (Psub) and intensity were measured with aerodynamic test using the Phonatory function analyzer (Nagashima Ltd. Model PS 77H, Tokyo, Japan). Closed quotients (Qx), jitter and shimmer were also investigated by electroglottography using Lx speech studio (Laryngograph Ltd, London, UK). These data were compared with those of normal controls. MFR and Psub were increased on high pitch tone in all subject groups. Statistically significant increasing of Qx and intensity were observed in male trained singers on high pitch tone (Qx;p = .025, intensity;p < .001). Beacasue of increasing of Qx and intensity, vocal efficiency was also significantly increased in male singers (p < .001). The trained singers' phonation was more efficient than untrained singers. The result means that the trained singers can increase the loudness with little changing of mean flow rate, subglottic pressure but more increasing of glottic closed quotients.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.39-45
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• 2000

Background and Objectives : Accent method is one of holistic approaches for behavior readjustment of voice therapy The aim of this study is to evaluate the efficacy of the accent method of voice therapy for the patients who have no improvement after LMS. Materials and Methods : Of the patients who had been undergone LMS during the period from Jan. 1999 to Dec. 1999, medical records of 38 patients who had not been improved were studied retrospectively. 19 patients(treatment group) were applied accent method and the other 19 patients(control group) refused voice therapy. The voice of all the patients of both group were analysed with CSL and Aerophone II programs in pre- and post operative period. The voice of treatment group were analysed with Visi-Pitch II program before the application of accent method and after the completion of accent method. Then, the results were compared using paired t-test. Results : The results of voice analysis were not different statistically between pre- and postoperative examination in both group. After application of accent method in the treatment group, fundamental frequency(F$_{0}$) of male, relative average pertubation, and shimmer were revealed significant differences(p＜0.01), and decrease in grade(G) scale and roughness(R) scale were statistically Important in perceptual analysis using GRBAS criteria(p＜0.01). But $F_0$ of female, maximal phonation time and S to Z ratio were not revealed significant differences. Conclusions : Accent method of voice therapy may be as a supplement- ary therapy in the patients who were not improved after surgery.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.46-50
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• 2000

Background and Objectives : Hormonal treatments which have an androgenic effect have the potential to cause vocal changes. The changes in vocal fold structure and voice quality are considered to be irreversible. To date, studies have documeted subjective vocal changes or documented single cases without detailed, baseline voice assessments. Materials and Methods : We have performed objective voice analyses of 20 women who were treated with androgenic hormones for endometriosis and compared the results with those of normal control women. Results : The averages of fundamental frequency were 194.7${\pm}$28.2 in study group, 207.0${\pm}$14.1 in control group. The means of closed quotient which were measured with electroglottography were 45.13${\pm}$2.06 in study group, 45.1${\pm}$3.03 in control group. Results of acoustic analysis are as follows. The averages of jitter were 0.95${\pm}$0.46 in study group, 1.10${\pm}$0.65 in control group. The means of shimmer were 2.44${\pm}$0.60 in study group, 2.32${\pm}$1.09 in control group. The averages of noise to harmonic ratio were 0.13${\pm}$0.028 in study group, 0.15$\pm$0.18 in control group. Conclusion : Although there were no statistically meaningful differences between the two groups, we could detect the masculinizing tendency of the therapeutic hormones of endomentriosiss(lowering of fundamental frequency). Given the availability of objective voice assessments today and the continued use of these potent hormones, comprehensive voice assessment and vocal monitoring would appear vital for women commencing hormonal treatment.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.134-137
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• 2007

Background and Objectives: The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. It is generally believed that the reconstruction of the glottic region after vertical partial laryngectomy (VPL) can improve laryngeal function. The objective of this study is to evaluate of voice function after VPL with mucosal flap and fat graft reconstruction. Materials and Methods: From 1994 to 2006, 13 patients, who had been treated with VPL with mucosal flap and fat graft reconstruction. The voice characteristics, acoustic, aerodynamic parameter were measured in 13 patients after vertical partial laryngectomy with mucosal flap and fat graft reconstruction. Acoustic analysis was carried out using Computerized Speech Lab (CSL) and aerodynamic analysis were carried out using Aerophon II,3 months and 12 months after surgery. Results: The GRBAS scale, jitter, shimmer, NHR were improved as time goes on after surgery. But, maximum phonation time was shortened after surgery and there is no significant differences between before and after surgery in mean flow rate. Conclusion: The voice function of the mucosal flap and fat graft reconstruction after VPL were satisfactory. This can be an excellent reconstruction method after vertical partial laryngectomy.

• 대한후두음성언어의학회지
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• 제29권1호
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• pp.37-40
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• 2018

Background and Objectives : This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. Materials and Methods : The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. Results : Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p<0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p<0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). Conclusion : Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

• 대한후두음성언어의학회지
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• 제10권1호
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• pp.43-49
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• 1999

Objectives : The purpose of this study was to systematically analyze and compare e acoustic sound structure of vocal major student's singing voice. Materials and Methods : The nineteen vocal major students were the subject group and healthy nineteen females were the control group for this study. The subject group was taken a strobovideolaryngoscopy by the use of flexible nasopharyngoscopy. And acoustic analysis was taken between two groups. Additionally the inquiry on usual voice problems and management was performed by thirty-six vocal major students. Results : The subject group presents many functional voice disorder findings such as AP contraction(44%), phase difference(36%) tremor(25%), posterior gap(17%), hyperadduction of vestibular fold(6%), and anterior gap(3%) on strobovideolaryngoscopy. And the vocal major students did reveal an enhanced number of high frequency harmonic partials when singing compared to the control group in the narrow band spectrum study. But there was no significant difference in jitter, shimmer and noise to harmonic ratio in both groups. Almost all vocal major students present a lot of voice problems in singing such as loss of high note(17%), loss of quiet voice(17%), effortful and tired voice(36%) etc on inquiry. And they always effort to prevent vocal dysfunction by the use of various type of method such as voice rest(28%), hydration(28%), gargling with salt(11%) etc. Conclusions : The vocal major students always take care of maintaining a good voice condition, but a lot of vocal major students revealed abnormal strobovideolaryngoscopic findings and they are absent in the conception of systemic and scientific voice management. Therefore, the young singers need a good voice training and voice therapy Program under the good ralationship of laryngologist and voice training teacher.

• 대한후두음성언어의학회지
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• 제15권1호
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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.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.27-30
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• 2004

Background and Objectives : The purpose of the present study is to investigate the effect of vocal hygiene education for the female elementary school teachers. Materials and Method : Thirty healthy female elementary school teachers were enrolled for the study. We provided a vocal hygiene education to the half of them. Voice handicap index and acoustic parameters were measured before and 4 week after the education. The efficacy of vocal hygiene education was analyzed by Wilcoxon Signed-rank test. Results : The vocal hygiene group showed significant improvement both in the subjective and objective data after the education. However, the non-vocal hygiene group failed to show any improvement. In functional score, emotional score, jitter, shimmer, only Junior Class(JC) could find significant after the education. Only low career(LC) could find significant in subjective data. Conclusion : Vocal hygiene education may be useful in reducing vocal misuse and abuse associated with teaching, and can be an effective method to maintain and improve the vocal health of teachers.