• Title/Summary/Keyword: Vocal Disorder

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The Study of Faulty Vocal Habits in Patients with Hoarsenes (애성환자에 있어서 잘못된 발성습관에 관한 연구)

  • 안철민;박정은
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.1
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    • pp.12-16
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    • 1999
  • Background and Objectives : The common cause of voice disorders may be bad habits of phonation. faulty vocal habits might aggravate the voice disorder or make the dysphonia. Authors thought the analysis of faulty vocal habits might help to evaluate the causes and to choose the treatment methods in patients with dysphonia. Authors studied to evaluate which vocal habits were used in patients with dysphonia. Materials and Methods : Patients with dysphonia(N= 32) and person without dysphonia(N=20) were evaluated through pre-evaluation test by otolaryngologist and SLP. All subjects were evaluated accordingly Posture of body, expansion of cervical vein, excessive movements of thyroide prominence, position of tongue, tension of lower lip, tension of jaw, breathing pattern related with phonation. Results : In dysphonia group, we found 23 cases with tension of jaw, 15 cases with expansion of cervical vein, 7 cases with bad position of tongue, 3 cases with excessive movement of thyroid prominence and a lot of cases with bad breathing Pattern on Phonation. In control group, only 3 cases with bad position of tongue, 2 cases with tension of lower lip, 1 case with tension of jaw were found. Conclusions : More faulty vocal habits were found in dysphonia group. Authors thought faulty vocal habits could be the cause of dysphonia and aggravate the dysphonia and the control of vocal habits would be very important in patients with dysphonia.

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Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice

  • Yeeji Sung;Soon-Beom Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.4
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    • pp.236-241
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    • 2023
  • Objectives: According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Methods: Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Results: Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Conclusion: Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.

A Case of Paradoxical Vocal Fold Movement with Severe Respiratory Distress (심한 호흡곤란을 동반한 역설성성대운동 1예)

  • Park, Jun Woo;Kim, Ji Won;Lim, Chae-Man;Choi, Seung-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.1
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    • pp.51-53
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    • 2015
  • Paradoxical vocal fold movement (PVFM) is characterized by aberrant vocal fold adduction. Although the exact pathogenesis is unknown, botulinum toxin injection, behavioral techniques, including speech therapy, bio-feedback, and cognitive-behavioral psychotherapy are considered for treatment of PVFM. The effectiveness of these treatments is not fully evaluated because of the rarity of disease. We present a case of 16-year-old female with sudden onset of respiratory distress associated with PVFM refractory to several treatments and spontaneously resolved later.

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A Case of Paradoxical Vocal Fold Movement Due to Psychological Causes (정신적 요인에 의한 역설적 성대운동 1예)

  • Shin, Dong Min;Park, Gi Cheol
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.3
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    • pp.142-145
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    • 2021
  • Paradoxical vocal fold movement (PVFM) is a dystonic laryngeal disorder characterized by involuntary vocal fold adduction during inspiration and/or expiration. PVFM is uncommon and may aggravate airway obstruction. And patients with PVFM have a specific etiology; therefore, treatment must be individualized and given immediately. We present a case of 63-year-old male presenting with intermittent dyspnea. After multidisciplinary workup, we presumed psychogenic PVFM and evaluated with speech-language pathologist and psychologist. In this report, we describe a rare case of psychogenic PVFM patient.

Adult Onset Tic Disorder Treated with Oriental Medicine and Habit Reversal Treatment : a Case Report (습관 반전 치료를 병행한 성인 틱장애 환자의 한방치험 1례)

  • Rhee, Yun Jin;Sun, Yung Chen;Kim, Kwang Hyuk;Moon, Byung Soon;Yun, Jong Min
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.5
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    • pp.765-772
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    • 2012
  • In this study, a patient with both motor and vocal tic disorders of onset at age 34 was treated for a total of 316 days. The characteristics of the tic symptoms of the patient were examined and treated two to three times a week with herbal medicine, acupuncture, cupping, and habit reversal treatment along with western medication prescribed to the patient from a psychiatric clinic. Furthermore, the condition of the patient was evaluated once a week by the Yale Global Tic Severity Scale(YGTSS-K). Both motor and vocal tic symptoms deceased to a great amount after treatment and the patient was able to lower the dosage of western medication with the approval of her psychiatric doctor. This case suggests that Oriental medical treatment undergone with habit reversal treatment could improve tic disorders better than sole western medication treatment.

Problems of Strobovideolarygoscopic Findings and Usual Voice Management of Vocal Major Students, and Acoustic Characteristics of Singing Voice (성악도들의 음성관리 및 성대화상술상의 문제점과 발성에 대한 음향분석학적 특징)

  • 진성민;김대영;반재호;이상혁;송윤경;권기환;이경철;이용배
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.1
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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.

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Screening of Voice Disorder using Source Parameter Model and Artificial Neural Network (음원 파라미터 모델과 인공신경망을 이용한 음성장애 검출)

  • Chytil, Pavel;Jo, Cheol-Woo;Pavel, Misha
    • Speech Sciences
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    • v.15 no.2
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    • pp.89-97
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    • 2008
  • There is a number of clinical conditions that affect directly or indirectly the physical properties of the vocal folds and thereby the pressure waveforms of elicited sounds. If the relationships between the clinical conditions and the voice quality are sufficiently reliable, it should be possible to detect these diseases or disorders. The focus of this paper is to determine the set of features and their values that would characterize the speaker's state of vocal folds. To the extent that these features can capture the anatomical, physiological, and neurological aspects of the speaker they can be potentially used to mediate an unobtrusive approach to diagnosis. We will show a new approach to this problem supported with results obtained from two disordered voice corpora.

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The Clinical Effect of Botulinum Toxin in a Patient with Tourette's Syndrome: A Case Report and Review (뚜렛 증후군에서 보툴리눔 톡신의 임상 효과 : 증례보고 및 고찰)

  • Hyun, Jung Keun;Lee, Jun Hyung;Lee, Chang Min;Lim, Myung Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.2
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    • pp.90-95
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    • 2013
  • Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer's cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300mg of botulinum toxin in an 18-year-old patient with Tourette's disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette's disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.

Management Principles of Bilateral Vocal Fold Immobility (양측성 성대 마비의 치료 원칙)

  • Kim, Tae-Wook;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.118-125
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    • 2009
  • Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

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Recent Trends in the Treatment of Voice Disorders: Evidence-based Practice and Translational Biology Research (음성 장애 치료 연구의 최근 동향: 증거에 기초한 임상 치료 및 전이 생물학적 연구)

  • Choi, Seong-Hee
    • Phonetics and Speech Sciences
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    • v.2 no.1
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    • pp.99-112
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    • 2010
  • This study attempted to review the recent, high-quality evidence-based practical research related to the treatment effectiveness of voice disorders which focus on randomized controlled trials (RCTs) and translational research of vocal fold tissue engineering for vocal fold regeneration. Methodology including PICO (P; Populations or Patients, I; Interventions, C; Comparison group (control, placebo, gold standard), O; Outcomes or measures made) information for RCTs and animal models (species), regenerative therapy method, and outcomes of translational research for clinical application was summarized and discussed for future voice disorder research.

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