• 말소리와 음성과학
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• 제16권1호
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• pp.11-16
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• 2024

The fundamental frequency (f0), representing an acoustic measure of vocal fold vibration, serves as an indicator of the speaker's emotional state and language-specific pattern in daily conversations. This study aimed to examine the f0 distribution in an English corpus of spontaneous speech, establishing normative data for American speakers. The corpus involved 40 participants engaging in free discussions on daily activities and personal viewpoints. Using Praat, f0 values were collected filtering outliers after removing nonspeech sounds and interviewer voices. Statistical analyses were performed with R. Results indicated a median f0 value of 145 Hz for all the speakers. The f0 values for all speakers exhibited a right-skewed, pointy distribution within a frequency range of 216 Hz from 75 Hz to 339 Hz. The female f0 range was wider than that of males, with a median of 113 Hz for males and 181 Hz for females. This spontaneous speech corpus provides valuable insights for linguists into f0 variation among individuals or groups in a language. Further research is encouraged to develop analytical and statistical measures for establishing reliable f0 standards for the general population.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.8.2-9
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• 1983

성대의 폴립 및 결절 등은 발성장애를 일으키는 가장 흔한 후두질환들이며 근래에는 후두미세수술(Laryngomicrosurgery)의 보편화에 따라서 그 수술성적에 있어서도 많은 개선이 이루어져 왔다. 그러나 오늘날 이러한 수술은 단순한 종물제거라는 개념을 넘어서서 술후에 따른 음성개선을 중요목적으로 하는 음성개선선수술 (phonosurgery)인 까닭에 수술에 따른 객관적이고도 정량적인 음성치료효과의 판정에도 관심을 기울여야 하겠다. 현재까지 시행되고 있는 수술후 치료효과의 판정에 대한 검사에 있어서는 대체로 공기 역학적 검사(aerodynamic study), 성대의 진동검사(vocal fold vibratory study), 음향분석검사(acoustic analysis), 청각심리검사( psychoacoustic evaluation)및 근신경검사(neuromuscular study)등이 시행되어지고 있다. 저자들은 1981년 6월부터 1983년 3월까지 1년 10개월간 본원 이비인후과에서 후두미세수술을 시행한 56예 의 성대 폴립 및 결절환자 중에서 수술전 및 수술 2개월 후에 상기할 일련의 음성 검사가 가능하였던 24예(성대폴립 15 예, 성대결절 9예)를 판정하여 다음과 같은 결과를 얻었다. 1) 최장발성지속시간 (Maximum phonation time)은 8예의 양측성 폴립에서는 술전에 비해 평균 40%가 증가되었으며 7예의 편측성 폴립에서는 평균 75.5 %가 증가되었다. 한편 7예의 양측성 결절에서는 평균 62 %, 2예의 편측성 결절에서는 18%가 각각 증가되었다. 2) 발성율(Phonation quotient) 양측성 폴립에서는 술전에 비해서 평균 25%가 편측성 폴립에서는 평균 2 6%가 각각 감소되었으며 또한 양측성 결절은 평균 55 %, 편측성 결절은 12%가 각각 감소되었다. 3 ) 평균호기유율(Mean air flow rate) 양측성 폴립에서는 평균 27%가 편측성 폴립에서는 평균 25 %가 각각 감소되었으며 양측성 결절에서는 평균 65 %가 편측성 결절에서는 25%가 각각 감소되었다. 4) 후두스트로보스코피 (Laryngo - stroboscopy )상으로 본 성대의 진동상 관찰에서 15예의 폴립에서는 술전 성문폐쇄 부전(Glottic chink)이 있었던 11예중 10예에서 성문폐쇄의 정상화, 대칭성의 회복 및 비진동성부위의 소실등이 관찰되었으며 9예의 결절에서도 술전 성문폐쇄부전이 있었던 7예 중 5예에서 소실되었다. 5 ) 청각심리검사 (Psychoacoustic evaluation)에서 폴립은 술전에 Grade 1∼2의 사성이 있었던 11예중 술후 10예에서 Grade 0로 되었으며 Grade 1∼2의 사성이 있었던 3예의 결절에서도 모두 Grade 0로 정상화되었다.

• 대한후두음성언어의학회지
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• 제17권1호
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• pp.28-37
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• 2006

Purpose: Evaluation of vocal cord vibration is very important in cases of voice disorders. There are several equipments for examining the vocal fold vibration such as laryngeal stroboscope, ultra high-speed digital imaging system, and videokymograph. Among these, laryngeal stroboscope is the most popular equipment because of easy to examine the laryngeal pathology. However, current laryngo-stroboscopes are too bulky to move and relatively expensive. The purpose of this research is to develope a portable laryngeal stroboscope of equivalent performance with the current equipments. Methods and Materials: Recently developed high luminescent white LEDs(light emitting diodes) are placed at the head of the endoscope as light sources for the CCD image sensor which is also placed at the head with imaging lens. This arrangement eliminates the bulky light source like expensive halogen or xenon lamps as well as the optical light guiding cables. The LEDs are controlled to flash in phase with the voice frequency of the examinee. The CCD captures these strobo images and converts them into video signals for examinations. Results: There was no functional differences between preexisting stroboscope and the newly developed stroboscope of this study. LED light sources and microprocessor based control circuits of the stroboscope enabled the development of flicker-less, hand-held, portable and battery-operating stroboscope. Conclusion: The developed stroboscope is cost-effective, small-sized, easy to use and very easy desirable to bring and to use in any place.

• 대한후두음성언어의학회지
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• 제33권3호
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• pp.166-171
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• 2022

Background and Objectives Vocal fold (VF) scar is known to be the most common cause of dysphonia after laryngeal microsurgery (LMS). Steroids reduce postoperative scar formation by inhibiting inflammation and collagen deposition. However, the clinical evidence of whether steroids are helpful in reducing VF scar formation after LMS is still lacking. The purpose of this study is to determine whether intralesional VF steroid injection after LMS helps to reduce postoperative scar formation and voice quality. Materials and Method This study was conducted on 80 patients who underwent LMS for VF polyp, Reinke's edema, and leukoplakia. Among them, 40 patients who underwent VF steroid injection after LMS were set as the injection group, and patients who had similar sex, age, and lesion size and who underwent LMS alone were set as the control group. In each group, stroboscopy, multi-dimensional voice program, Aerophone II, and voice handicap index (VHI) were performed before and 1 month after surgery, and the results were statistically analyzed. Results There were no statistically significant differences in the distribution of sex, age, symptom duration, occupation and smoking status between each group. Both groups consisted of VF polyp (n=21), Reinke's edema (n=11), and leukoplakia (n=9). On stroboscopy, the lesion disappeared after surgery, and the amplitude and mucosal wave were symmetrical on both sides of the VFs in all patients. Acoustic parameters and VHI significantly improved after surgery in all patients. However, there was no significant difference between the injection and control group in most of the results. Conclusion There was no significant difference in the results of stroboscopy, acoustic, aerodynamic, and subjective evaluation before and after surgery in the injection group and the control group.

• Journal of Chest Surgery
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• 제48권6호
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• pp.387-392
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• 2015

Background: The aim of this study was to evaluate the feasibility of single-port video-assisted thoracic surgery (VATS) in the treatment of secondary spontaneous pneumothorax (SSP). Methods: Twenty-four patients who were scheduled to undergo single-port VATS for SSP were studied. The medical records of the patients were retrospectively reviewed. The mean follow-up duration was $26.1{\pm}19.8$ months. In order to evaluate the feasibility of single-port VATS for SSP, the postoperative results of single-port VATS (n=15) in patients with emphysema were compared with those of emphysematous patients who underwent three-port VATS (n=15) during the study period. Results: Single-port VATS was feasible in 19 of 24 patients (79.2%), while an additional port was needed in five patients. In the single-port VATS patients, the median operation time, duration of chest tube drainage, and hospital stay were 84.0 minutes, one day, and two days, respectively. Postoperative complications included prolonged chest tube drainage for more than five days (n=1), wound infection (n=1), and vocal fold palsy (n=1). No recurrence of pneumothorax was observed during the follow-up period. The median operation time, duration of chest tube drainage, and hospital stay of the emphysematous patients who underwent single-port VATS were shorter than those who underwent three-port VATS group (p<0.05 for all parameters). Conclusion: Single-port VATS proved to be a feasible procedure in the treatment of patients with secondary spontaneous pneumothorax.

• 대한후두음성언어의학회지
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• 제18권2호
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• pp.96-101
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• 2007

Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.127-132
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• 2006

Background and Objectives : Functional dysphonia is a voice disturbance in the absence of structural or neurologic laryngeal pathology characterized by voluntary misuse of laryngeal muscles. The present report reviews clinical characteristics of 25 patients with functional dysphonia. Materials and Method : We analyzed medical records, perceptual and acoustic analysis of voice samples, aerodynamic studies and laryngoscopy. Results : There was no sex or age predilection. Eighty four percent of patients presented sudden onset of symptoms and 76% had specific events at the onset. Most patients showed breathy or strained voice and various degree of vocal fold insufficiency with supraglottic compensatory contractions. Acoustic analysis revealed non-diagnostic, but mean flow rate was lower than normal in all cases. All patients responded to voice therapy except for 4 patients who were tort to follow up. Mean number of voice therapy sessions required to get responses is 1.9 sessions. Conclusion : We concluded that patients with functional dysphonia responded very well to short-term voice therapy and should be included in differential diagnosis in patients with dysphonia cannot be explained by structural or neurologic etiology.

• 대한후두음성언어의학회지
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• 제23권1호
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• pp.52-55
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• 2012

Background and Objectives : Based on histological findings, intracordal cysts are divided in two subtypes : retention cysts and epidermoid cysts. They are typically located in the superficial layer of the lamina propria and appeared as opaque ovoid buldging masses underlying the epithelium. They are characterized by unilateral diminished mucosal wave on stroboscopy. In this article, we report some cases of patients with an oval shaped-yellowish flat cyst. Materials and Method : At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 female complained of hoarseness as subjects, using the stroboscopy we checked preoperative and postoperative vocal cord and operative findings. Surgery was performed under general anesthesia by the senior authors. All patients noted subjectively that their performing voice was improved. Results : During surgery, an oval shaped-yellowish flat cystic lesion was distinguished from normal epithelium. On palpation of this area with microforceps and cottons, the yellowish discharge was noted to move out from the opening of the cyst. In one case, the cyst was ruptured but remove the capsule completely. In other cases, sulcus was noted at the oppsite site. Conclusion : Because of the opening, the cyst was not easy to dissect and remove completely. After the debris was move out, fibrosis around the opening and invaginated epithelium extending into the deeper layers to the fold. The cyst was must removed carefully and completely for improvement of voice quality before evolving into a sulcus vocalis.

• 대한후두음성언어의학회지
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• 제20권1호
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• pp.36-41
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• 2009

Background and Objectives: Topical administration of mitomycin-C (MMC) has been reported to reduce or delay scar formation in airway surgery. However, it is not infrequent to experience recurrent stenosis or adhesion of operative wound even after a meticulous MMC application during the laryngeal surgery. Therefore we aimed to evaluate the effectiveness of repeated postoperative MMC applications and the technical feasibility of MMC applications to the laryngeal wound at an outpatient clinic. Methods: We reviewed medical records of 13 consecutive patients who received office-based MMC applications after laryngeal airway surgery at Samsung Medical Center, Seoul, Korea. The patients were grouped into 3 categories according to the site of surgical wound and the purpose of MMC application; group I : supraglottic stenosis (n=5), group II : cordectomy and arytenoidectomy site granulation prevention (n=3), Group III : laryngeal web prevention (n=5). Outcomes in each group and adverse effects of repeated MMC applications were evaluated. Results: Office-based MMC application was successfully performed one to four times with a week interval for each patient. No significant complications were observed except slightly decreased mucosal wave in one female patient who received 4 times of MMC application at the anterior commissure of vocal fold. Repeated MMC applications at the outpatient clinic resulted in wide or acceptable supraglottic airway in group I, clean wound healing without granulation formation in group II, and negligible or no web formation at the anterior commissure in group III. Conclusion : Office-based topical administration of MMC to the larynx was technically feasible. Postoperative repeated MMC applications were effective to reduce recurrent stenosis or adhesion of supraglottic structures, to prevent granuloma formation after laser arytenoidectomy and glottic web formation after anterior commissure resection.

• 대한후두음성언어의학회지
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• 제8권2호
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• pp.199-203
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• 1997

In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using a flexible nasopharyngoscope was conducted in 29 patients and using a telearyngoscope in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under flexible nasopharyngoscopic guidance with sclerosing needle or telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 60 patients, 59 patients were given the toxin successfully. Telephone interview were made at 2weeks and then at 4 weeks post injection. Among 29 patients using a flexible nasopharyngoscope, 75.8% and among 31 patients using a telelaryngoscope, 90.0% reported that the patients' symptom was improved. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade fir the patients using flexible nasopharyngoscope and telelaryngoscope was 1.6 and 2.1 respectively. And it was lowered to 0.7 and 1.1 respectively after the injection. The result was similar(p<0.05). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 44 and 40 respectively. And it was improved to 77.7 and 69.8 respectively after the injection. The result was similar(p<0.05). In conclusion, botulinum toxin injection using a flexible nasopharyngoscope is also an effective method for the treatment of adductor type spasmodic dysphonia as using a telelaryngoscope.