• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.20-27
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• 2000

To determine what is the change of pre and postoperative voice and image analysis parameters and correlations between them, videostroboscopy was analyzed in each 18 patients with unilateral vocal cord paralyses or vocal polyps before and after the surgery from November, 1996 to April, 1999. The correlation between acoustic and aerodynamic parameters was investigated. The software-Videolink and $\pi$-View(Mediface Co, Seoul, Korea)-was used in a quantitative analysis. In unilateral vocal cord paralysis, the glottic angle is well correlated with maximum phonation time, jitter and shimmer preoperatively. The postoperative glottic angle is also correlated with preoperative maximum phonation time. In patients with the vocal polyp, the chink is postoperatively decreased, but the size of the chink and the polyp is not correlated with pre and postoperative voice analysis parameters. These findings reveal that glottic an and vocal fold angle are good indicators of e postoperative glottic configuration in unilateral vocal cord paralysis. Vocal fold ratio is also a useful indicator that represents the length of vocal folds. We consider that the computerized analysis through videostroboscopy is one of objective diagnostic methods in many voice disorders if we can measure a distance between the telelaryngoscope and vocal folds.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.71-78
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• 1998

Type Ⅰ thyuroplasty in conjunction with arytenoid adduction is one of the excellent techniques in the treatment of unilateral vocal fold paralysis. But perioperative objective evaluation of the patients is difficult. With the development of the videostroboscopy and image analysis program, we could quantify the Glottal Area Waveform(GAW) in patients with unilateral vocal fold paralysis and investigated the relationship between the glottal area and aerodynamic and acoustic parameters. Eight female patients who were performed type Ⅰ thyroplasty in conjunction with arytenoid adduction and 5 females with normal vocal function were involved in this study. Preoperative and postoperative videostroboscopy and vocal function study wire performed. GAW was analysed quantitatively with image analysis program (Kay Stroboscope Image analysis, KSIP) Peak Glottal Area(PGA), Baseline Offset(BO), and Closing Phase(CP) were increased in patients with unilateral vocal fold paralysis and they were reduced after the operation. Mean flow Rate (MFR) was well correlated with the PGA in normal control group and unilateral vocal fold paralysis patients. Noise to harmonic ratio(NHR) was correlated with PGA only in preoperative unilateral vocal fold paralysis patients. In conclusion quantitative measurement of the GAW is useful method in evaluation of unilateral vocal f31d paralysis patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.12-19
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• 2000

Background and Objectives : Dysphonia may be secondary to many different type of benign vocal cord lesions such as vocal polyp, vocal nodule, Reinke's edema, and intracordal cyst. Diagnosis and treatment of intracordal cysts are more difficult than other benign vocal cord lesions. But postoperative voice analysis of intracordal cyst have rarely been reported in the literature. The purpose of this study is to analyze aerodynamic and acoustic results and videostroboscopic findings before and after laryngomicrosurgery. Materials and Methods : We reviewed the pre and post-operative voice analysis results and videostroboscopic findings of 15 surgically treated patients of intracordal cysts at Severance hospital from Jun. 1997 to Nov. 1999 retrospectively. They were diagnosed with videostroboscopic findings, surgical findings, and pathologic reports. Their pre and post-operative speech were analyzed with MDVP(Multi Dimension Voice Analysis Program) of CSL(Computerized Speech Lab) and Aerophone II. Their pre and post-operative mucosal wave of true vocal cord was analyzed with videostroboscopy. In order to compare this results with normal group, 10 of normal persons were evaluated with same methods. Results : After the operation, mucosal wave of true vocal cord was improved in all patients. Postoperative acoustic and aerodynamic results were improved in almost parameters, but they did not reach the normal value. Conclusions : Videostroboscopy was essential in diagnosing intracordal cysts. By comparing the acoustic and aerodynamic results and video-stroboscopic findings before and after the laryngomicrosurgery, postoperative vocal function was defined more accurately and objectively. Almost parameters may be useful in assessing the quantitative changes in vocal quality before and after the laryngomicrosurgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.33-39
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• 2002

Background and Objectives : The vocal fold nodules which were made by excessive contact or vibration of the vocal folds were classified to the soft nodule and the hard nodule in according to the hardness or the duration of nodule. Sometimes laryngologist saw the nodule to be located in different level. Authors thought that each nodule to be located in different level might have the different causes. Therefore we studied to know the relationship between the voicing technique and each vocal fold nodule to be located in different level. Materials and Methods : One-hundred forty nine patients who had the vocal fold nodule were evaluated. Sites and shapes of the vocal fold nodules were investigated using videostroboscopy. Videokymography was also used to scan the center of the vocal fold nodules during phonation and classified to several types. Same procedures were done on normal subject while he simulated the various types of voicing. And we compared the findings between both of them. Three different types of lesion can be distinguished. These are ML group that lesions were located from mid to low, MH group that lesions were located from mid to upper and HL group that lesions were located from lower to upper of the vocal folds. Results : The VKG findings of ML group and situation simulating with hard glottal attack and vocal fry were similar. MH group had a similar VKG findings with situation simulating with whispering or high pitch voicing. HL group had a similar VKG findings with situation simulating with loud voicing. Conclusions : Authors thought that each vocal fold nodule, which had different shapes and located in different level, related with the different types of voicing.

• Phonetics and Speech Sciences
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• v.10 no.4
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• pp.155-161
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• 2018

The purpose of this study was to evaluate the efficacy of a multiple voice therapy technique ($SKMVTT^{(R)}$) using laughter for the treatment of various benign vocal fold lesions. To achieve this, 23 female patients diagnosed with vocal nodules, vocal polyp, and muscle tension dysphonia through videostroboscopy were enrolled in vocal hygiene and $SKMVTT^{(R)}$. All of the patients were treated once a week for 4 to 12 sessions. The GRBAS scale was used to confirm the changes in voice quality before and after the treatment. Acoustic analysis was performed to evaluate jitter, shimmer, NHR, fundamental frequency variation, amplitude variation, PFR, and dB range. Videostroboscopy was performed to confirm the changes in the laryngeal features before and after the treatment. After the $SKMVTT^{(R)}$, the results of the perceptual evaluation demonstrated that the G, R, and B scales significantly improved. An acoustic evaluation also demonstrated that jitter, shimmer, NHR, vAm, vFo, PFR, and dB range also significantly improved after the $SKMVTT^{(R)}$. In comparison to the videostroboscopic findings, the size of the vocal nodules and vocal polyp decreased or disappeared after the treatment. In addition, the size of the cuneiform tubercles decreased, the length of the aryepiglottic folds became longer, and the laryngeal findings of the supraglottic compressions improved after the $SKMVTT^{(R)}$. These results suggest that the $SKMVTT^{(R)}$ is effective in improving the vocal quality of patients with benign vocal fold lesions. In conclusion, it seems that laughter and inspiratory phonation suppressed abnormal laryngeal elevation and lowered laryngeal height, which seems to have the effect of improving hyperfunctional phonation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.5-9
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• 2005

Background and Objectives : Glottal area waveform(GAW) shows the plot of glottal area versus time through the 1 cycle. This study is designed to see how it can be applied to laryngeal patients. Material and Methods : A GAW analysis was peformed on 11 patients before and after surgery and 22 persons without laryngeal problems were recruited for control. Acoustic and aerodynamic analysis with VHI(voice handicap index) evaluation were performed. Results. Significant changes in baseline offset, gross closing rate and VHI were observed postoperatively. Other parameters were changed but insignificant. Conclusion : GAW maybe used to evaluate patient with voice problems.

• Proceedings of the KSLP Conference
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• 2016.03a
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• pp.49-49
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• 2016

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.3 no.1
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• pp.22-28
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• 1989

Laryngostroboscopy is one of the most practical techniques for clinical examination of the larynx. The videostroboscopy provides valuable information concerning the nature of vocal folds' vibration, an immediate image of the presence or absence of pathology, and a permanent record. Additionally, when used by trained observers in conjunction with other instrumentation, it can provide both qualitative and quantitative data on vocal function of both the normal and disordered larynx. The authors examined the 388 patients with voice disorders by videostroboscope. This paper describes the clinical procedure of laryngostroboscopy based on some introductory remarks on laryngeal anatomy and function. And the findings of parameters observed by the stroboscopy is noted for the laryngeal disorders.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.2
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• pp.121-127
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• 2010

Background and Objectives : Unilateral vocal fold paralysis is generally treated using injection laryngoplasty or voice therapy. However, the decision of treatment method is dependent on clinician's preference and hospital facilities without specific criteria. The purpose of the study was to examine factors predictive of voice therapy outcome in patients with unilateral vocal fold paralysis. Materials and Method : 38 patients diagnosed as unilateral vocal fold paralysis, aged from 24 to 81 years and undergone voice therapy more than 1 month were included. After 3 to 12 (mean 5.1) sessions of voice therapy, subjects had divided into responder group (RG, 28 patients) and non-responder group (NRG, 10 patients) according to G scale change. Paramters of perceptual assessment, acoustic and aerodynamic measure, and videostroboscopy were compared between two groups, and factors predictive of voice therapy result were analyzed. Results : RG patients showed significantly reduced rough, breathy, asthenic voice after voice therapy. Change of MPT and MFR was more substantial in RG than in NRG. By videostroboscopy, RG patients showed significantly more mucosal wave symmetry, glottal closure, reduced glottal gap index during the closed phase of phonation, while NRG patients showed more occurrences of abnomal supraglottic activities during phonation (p < 0.05). Poor outcome of voice therapy significantly associated with increased asthenic scale, short MPT, and less glottal closure (p=0.02). In addition, 90% of patients with MPT more than 5 seconds were in RG, whereas 56% of patients with MPT less than 5 secondes were in RG. Conclusion : Voice therapy is useful for large proportion of patients with unilateral vocal fold paralysis as an initial treatment method. However, patients with large asthenia scale, large glottic gap or MPT less than 5 seconds tend to have poor voice therapy outcome, and early injection laryngoplasty maybe recommended for these patients.