• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.82-85
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• 2014

Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

• 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.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.2
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• pp.111-119
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• 2001

Tic disorder which is purposeless, repeated, unexpected, involuntary behavior and voice can be divided into motor, vocal tic. Tic disorder belongs to pediatic psychosomatic disease. In four clinical cases, patients between the age of 6 to 15 consisted of three males and one females. They all are the eldest or only son and have the parental behavioral, home background and studing problem. The patients appealed to eye blinking in tic early stage and belong to chronic motor or vocal tic disorder or transient tic disorder without tourette's disorder. When estimated by an appraisal standard of Yale Global Tic Severity Scale(YGTSS). Four patients administered Bosimgeunatang known to invigorating the heart, relieving mental stress improved.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.9-14
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• 2021

Spasmodic dysphonia, essential tremor, and vocal tremor related with Parkinson's disease are different disorders showing fairly similar symptoms such as difficulty in the speech onset, and tremble in the voice. However, the cause and the resulting treatment of these diseases are different. Spasmodic dysphonia is a vocal disorder characterized by spasms of the laryngeal muscles during a speech, invoking broken, tense, forced, and strangled voice patterns. Such difficult-to-treat dysphonia disease is classified as central-origin-focal dystonia, of a yet unknown etiology. Its symptoms arise because of intermittent and involuntary muscle contractions during speech. Essential tremor, on the other hand, is characterized by a rhythmic laryngeal movement, resulting in alterations of rhythmic pitch and loudness during speech or even at rest. Severe cases of tremor may cause speech breaks like those of adductor spasmodic dysphonia. In the case of hyper-functional tension of vocal folds and accompanying tremors, it is necessary to distinguish these disorders from muscular dysfunction. A diversified assessment through the performance of specific speech tasks and a thorough understanding for the identification of the disorder is necessary for accurate diagnosis and effective treatment of patients with vocal tremors.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.4
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• pp.118-124
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• 2014

Objectives The purpose of this study is to report 20 cases of tic disorder children who were treated by Kuibiondam-tang Gami. Methods We treated the tic disorder children with herbal medicine, Kuibiondam-tang Gami. Then we evaluated tic disorder by Yale Global Tic Severity Scale (YGTSS) and observed the progress of tic disorder. Results 20 children (male 17, female 3 / transient tic disorder 6, chronic motor or vocal tic disorder 13, Tourette's disorder 1) were studied, the average age of children was $8.45{\pm}2.08$ years, the average duration of illness was $16.55{\pm}13.63$ month and the mean of treatment was $13.20{\pm}9.29$ week. After the treatment, mean of YGTSS was reduced $36.35{\pm}9.84$ to $9.35{\pm}1.03$ and total effective rate was 95%. Conclusions Kuibiondam-tang Gami is effective for reducing tic symptom and improving general conditions in children.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.71-78
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• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

• Journal of Oriental Neuropsychiatry
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• v.20 no.1
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• pp.119-146
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• 2009

Objectives : In this study, patients with tic disorders who visited an Oriental medicine clinic were examined for their demographic characteristics, characteristics of symptoms, relation to Attention-deficit Hyperactivity Disorder(ADHD) and peculiarity according to various variables such as motor and vocal tics. Methods : After surveying 292 patients who visited an Oriental medicine clinic with tic symptoms as main complaints for 17 months, SAS 9.1, a statistical program was used for statistical analysis. Results : 1. The BMI of male tic patients was significantly higher than female ones and it was similar to or higher than the normal group. 2. Patients who are eldest children were 1.7 times higher than those who are not eldest ones. 3. The most usual case of motor tics was the eye blink and the most one of vocal tics was a dry cough. 4. There was no significant difference between male and female patients for all symptoms of motor and vocal tics, but male patients had significantly more obsessions related to tics than female ones. 5. There was no significant difference in the age of initial occurrence of Transient tic disorder(TTD), Chronic tic disoder(CTD) and Tourette's disorder(TD). 6. For the general disorder of a tic and Conners' ADHD rating scale, there was no significance in TTD, CTD and TD. 7. 66% out of the total subjects of 197 cases were found to score more than 65 points in more than 1 items among 8 items such as the time, hearing, wrong alarm, mean response time and standard deviation in the response time, etc. of the ADHD diagnosis system(ADS). 8. The eye blink among motor tics was shown mainly by patients under 10 years old and the frown, movement of the head, shrug and movement of the arms were shown mainly by 11-19 years old patients. Conclusions : For the number, frequency, seriousness and inconvenience in life of tics, TD showed a significantly higher result than TTD and CTD.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.117-121
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• 2015

Background : Cepstral analysis which is obtained from Fourier transformation of spectrum has been known to be effective indicator to analyze the voice disorder. To evaluate the voice disorder, phonation of sustained vowel /a/ sound or continuous speech have been used but the former was limited to capture hoarseness properly. This study is aimed to compare the effectiveness in analysis of cepstrum between the sustained vowel /a/ sound and continuous speech. Methods : From March 2012 to December 2014, total 72 patients was enrolled in this study, including 24 unilateral vocal cord palsy, vocal nodule and vocal polyp patients, respectively. The entire patient evaluated their voice quality by VHI (Voice Handicap Index) before and after treatment. Phonation of sustained vowel /a/ sample and continuous speech using the first sentence of autumn paragraph was subjected by cepstral analysis and compare the pre-treatment group and post-treatment group. Results : The measured values of pre and post treatment in CPP-a (cepstral peak prominence in /a/ vowel sound) was 13.80, 13.91 in vocal cord palsy, 16.62, 17.99 in vocal cord nodule, 14.19, 18.50 in vocal cord polyp respectively. Values of CPP-s (cepstral peak prominence in text-based speech) in pre and post treatment was 11.11, 12.09 in vocal cord palsy, 12.11, 14.09 in vocal cord nodule, 12.63, 14.17 in vocal cord polyp. All 72 patients showed subjective improvement in VHI after treatment. CPP-a showed statistical improvement only in vocal polyp group, but CPP-s showed statistical improvement in all three groups (p<0.05). Conclusion : In analysis of cepstrum, text-based analysis is more representative in voice disorder than vowel sound speech. So when the acoustic analysis of voice by cepstrum, both phonation of sustained vowel /a/ sound and text based speech should be performed to obtain more accurate result.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.3
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• pp.124-129
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• 2021

Background and Objectives This study compares Vocal Fatigue Index (VFI) scores according to the presence or absence of external laryngeal tension in hyperfunctional voice disorder. And through this, it is to confirm the usefulness of VFI to hypertension of extrinsic laryngeal muscles. Materials and Method The subjects were 61 female diagnosed with hyperfunctional voice disorder (hypertension group 41, non-hypertension group 20). The author palpated extrinsic laryngeal muscles for evaluation of hypertension and classified them as the presence or absence. The voice measurements were jitter, shimmer, Korean-Voice Handicap Index-10 (K-VHI-10), and Korean-Vocal Fatigue Index (K-VFI). The voice compared were according to the diagnosis and presence of hypertension only for patients with hyperfunctional voice disorder. Results As a result of comparing the voice measurement according to the presence or absence of hypertension, there was no significant difference in the acoustic variables, K-VHI-10 and K-VFI-Total, K-VFI-Fatigue. Whereas, K-VFI-Physical (p=0.006) and K-VFI-Rest (p=0.022) were significantly higher in the hypertension group. Conclusion These results indicate that the hypertension group has more physical discomfort and less voice recovery than the group without hypertension. It means that K-VFI can measure the physical discomfort and limitations of voice recovery due to hypertension of the external laryngeal muscle. The VFI can be used as one of the methods to evaluate the hypertension of the external laryngeal muscle in Hyperfunctional voice disorder.