• Phonetics and Speech Sciences
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• v.3 no.3
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• pp.149-155
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• 2011

The purpose of the present study was to identify the differences in GRBAS scales between vocal sample types (sustained vowels and connected speech) for specific laryngeal conditions (vocal nodules, vocal polyps and vocal paralysis) and the relations between GRBAS scale and Shimmer value in each vocal sample type. In this study, the total of 60 voice samples of 30 patients (10 vocal nodules, 10 vocal polyps, 10 vocal paralysis) were examined and MDVP (Multi-dimensional Voice Program) was used to analyze Shimmer value. Three listeners rated two types of samples which were sorted randomly based on GRBAS scale. Three-way ANOVA, one-way ANOVA and paired t-test were used. The outcome of this study was as follow. 1) GRBAS scales varied in vocal sample types. Listeners tended to assess voices as better quality when they listened connected speech rather than sustained vowels. 2) G score of GRBAS and Shimmer were positively correlated with statistical significance. This results show that 1) vocal specialists should consider the sample types in evaluating the severity of voice problem and 2) G score could be a simple and clear method.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.122-128
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• 2007

This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.28-32
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• 2012

Vocal fold scar disrupts structure of lamina propria and causes significant change in vocal fold tissue biomechanics, resulting in a range of voice problems that often significantly compromise patient quality of life. Although several therapeutic management have been offered in an attempt to improve vocal fold scar, the ideal treatment has not yet been found. Recently, several tissue engineering technique for vocal fold scar using growth factors, several cells, and scaffolds have been described in tissue culture and animal models. Several growth factors such as hepatocyte growth factor, basic fibroblast growth factor, and transforming growth factor beta 3 for therapy and prevention of vocal fold scar have been studied. Cell types to regenerate vocal folds in scarring tissue have been introduced autologous or scarred vocal fold fibroblast and adult mesenchymal stem cells. Decellularized organ matrix and several hyaluronic acid materials have used as scaffolds for vocal fold scar.

• Korean Journal of Bronchoesophagology
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• v.1 no.1
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• pp.64-68
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• 1995

Vocal folds injury from vocal abuse is important topics of phonosurgery. Recent advances in diagnostic equipment, phonosurgery and speech analysis equipment have provided a lot of Information about fine movement of the vocal folds. However, predicting the reaction of the vocal folds to phonatory trauma remains difficult. The vocal folds need to withstand great vibratory and shearing stress and anchoring fibers of basement membrane Bone play a role in maintaining structural integrity of histologically different epidermis and superficial layer of lamina propria(cover of vocal folds). The purpose of this study is to demonstrate the changes of anchoring fibers in vocal polyp using transmission electron microscope. Various defects were observed : a irregular thickening of basement membrane, a near absence of normal anchoring fiber, a lot of electron dense material in superficial layer of lamina propria, a destruction of hemidesmosome and many vesicles carrying electron dense material In basal keratinocyte. These observations were suggestive of a hyperactivity of basal keratinocyte of vocal folds epithelium in response to vibratory stress.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.12 no.11
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• pp.5541-5554
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• 2018

A voice is one of the most significant non-verbal elements for communication. Disorders in vocal organs, or habitual muscular setting for articulatory cause vocal disorders. Therefore, by analyzing the vocal disorders, it is possible to predicate vocal diseases. In this paper, a method of predicting vocal disorders using the jitter, shimmer, and harmonics-to-noise ratio (HNR) extracted from vocal records is proposed. In order to extract jitter, shimmer, and HNR, one-second's voice signals are recorded in 44.1khz. In an experiment, 151 voice records are collected. The collected data set is clustered using cobweb clustering method. 21 classes with 12 leaves are resulted from the data set. According to the semantics of jitter, shimmer, and HNR, the class whose centroid has lowest jitter and shimmer, and highest HNR becomes the normal vocal group. The risk of vocal disorders can be predicted by measuring the distance and direction between the centroids.

• The Journal of the Acoustical Society of Korea
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• v.30 no.6
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• pp.353-359
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• 2011

This paper proposes a vocal enhancement technique for improving the performance of vocal pitch detection in polyphonic music signal. The proposed vocal enhancement technique predicts an accompaniment signal from the input signal and generates an accompaniment replica signal according to the vocal power. Then, it removes the accompaniment replica signal from the input signal, resulting in a vocal-enhanced signal. The performance of the proposed method was measured by applying the same vocal pitch extraction method to the original and the vocal-enhanced signal, and the vocal pitch detection accuracy was increased by 7.1 % point in average.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.43-49
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• 2009

Vocal polyps are benign phonotraumatic lesions which are traditionally treated using phonomicrosurgical techniques. In the case of hyperfunctional voice use, voice therapy is effective and results in voice improvement. However, the utility of voice therapy about vocal polyp is in great demand. The purpose of this study was to evaluate the effects of voice therapy in patients with vocal polyps. The authors reviewed the medical records of 193 patients with vocal nodules or vocal polyps, and 64 patients (31 nodules and 33 polyps) were enrolled. All of the subjects had received explanation of problems, vocal hygiene education, and been treated by the $SKMVTT^{(R)}$ (Seong-Tae Kim's multiple voice therapy technique) ranging from 4 to 16 sessions (mean: 8.6 sessions). All subjects were examined by perceptual assessment, acoustic and aerodynamic measures, and VRP (voice range profile). In perceptual assessment, patients with vocal nodules had more breathy and strained voices than the vocal polyp group. Both groups significantly reduced rough, breathy voice after voice therapy. Patients with vocal polyps had worse voice quality than patients with nodules in acoustic measures. Both groups showed reduced jitter and shimmer after voice therapy. In aerodynamic measures, MPT and Psub were increased, and MFR was reduced (p<.05). Participants' frequency range and intensity range were increased after voice therapy, but only frequency range resulted in a significant difference (p<.05). In conclusion, the therapeutic effect of voice therapy in patients with vocal nodules and polyps was demonstrated perceptually and acoustically. We can suggest that voice therapy, including advice, vocal hygiene, and $SKMVTT^{(R)}$ is a useful as an initial choice of treatment for patients with vocal polyps before considering a surgical approach.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.5-17
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• 2002

Objectives : Videostrobokymography(VSK) has been recently developed and reported by Sung et at. We aimed to analyze vibratory patterns and objective parameters in various benign vocal fold lesions using VSK, and examine the efficacy of VSK in clinical application. Materials and Methods : Using VSK, we analyzed the vibration pattern of normal vocal fold and various benign lesions, such as nodules, polyps, cysts, Reinke's edema and unilateral vocal fold paralysis. We also calculated objective parameters, open quotient and asymmetric index, and compared them with mean values of parameters in normal controls. Results : In nodules, polyps, and cysts, the open quotient on the site of the lesion was similar to the mean value in normal controls, however, on the other part of the vocal folds it was much larger than normal mean value. In Reinke's edema, irregular and asymmetric vibration was observed. The posterior portion of the vocal folds showed larger open quotients than the anterior portion. In the unilateral vocal fold paralysis, irregular vocal folds vibration and incomplete closure of the vocal folds were documented. Much larger asymmetric indices were calculated in the unilateral vocal fold paralysis than in normal controls and other lesions. The asymmetric index could be a good quantitative parameter of vibration from a patient with vocal fold paralysis. Conclusion : This study demonstrated that VSK could generate clear quantitative documentations of fine vibrations of vocal folds in many different benign lesions. VSK has a potential as an effective tool for quantitative analysis of vibratory patterns of the vocal folds iii clinical settings.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.1
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• pp.61-63
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• 2001

The mucosal bridge of the vocal fold is an arch of mucosa, formed by some portion of the vocal fold mucosa which is detached in various extension and length. The etiology is uncertain but some is related to vocal sulcus. Because it affects the voice with variable impact, it must be differentiated from functional voice disorder. We report a case of a mucosal bridge of vocal fold with a vocal polyp treated by microlaryngeal surgery and voice therapy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.6 no.1
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• pp.5-8
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• 1995

Bilateral vocal cord palsy is uncommon but is serious because of airway obstruction. Treatments of bilateral vocal cord palsy are initially tracheotomy, vocal cord lateralization and vocal cord reinnervation. Recently, we experienced nerve-muscle pedicle reinnervation in 3 cases of bilateral vocal cord palsy, so reported it with a review of literature.