• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.68-75
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• 2005

The treatment of sulcus vocalis and vocal bowing has been commonly used Thyroplasty Type surgery or injection within vocal folds such as Teflon, silicone, collagen. However, and treatment has not been acquired satisfactory treatment effect. This study was conducted to demonstrate voice therapy effect using singer's vocal technique and respiratory training. 4 patients (1 male, 3 females) with sulcus vocalis or bowing, with or without scar were selected for this study and we compared with acoustic, aerodynamic measures and stroboscopy observation before and after voice therapy. The results showed that 1) case 1 (48yr, male) with sulcus vocalis decreased F0 (Fundamental Frequency), increase CQ(Close Quotient) and high degree of satisfaction but not improved voice quality after voice therapy. 2) case 2(19yrs, femal) with mild sulcus vocalis improved as normal voice quality after voice therapy. 3) case 3(38yrs, female) with functional bowing showed abnormalvocal contact before therapy whereas CQ was increased after voice therapy. 4) case 4(27yrs, female) with vocal atrophy and vocal bowing changed normal range of Fo and increased CQ after voice therapy. Even though contact area of both vocal folds was increased and lowered F0 after voice therapy, current outcomes revealed that normal voice quality was not regained. These results might signify that it was difficult that vocal folds couldn't be recovery of symmetry and viscoelastic property of mucosal wave through voice therapy. However, it was difficult for this study to maintain voice therapy so that evaluate effect of voice therapy for long-term. Further study will be needed to long-term follow-up for voice therapy with these patients.

• Speech Sciences
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• v.15 no.2
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• pp.169-176
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• 2008

This study was intended to analyze difference of vocal folds movements between upon wakeup and in several hours later in the morning. The difference of vocal fold movements was compared with fundamental frequency and a range of fundamental frequencies from maximum to minimum. The participants were 30 female adults between 20 and 29 years old. Voice samples were collected from their reading sentence (Jeong, 1993). The first sampling was conducted within 5 minutes after wakeup, while the second on 1 hour after the first sampling. Finally, the third voice sample was collected on 6 hours after the second sampling. The results of this study were as follows: First, fundamental frequency of the participants were by hour significantly time-dependent(F=7.843). Post-hoc multiple comparison (LSD) was conducted to determine when the difference could be observed. The result showed significant differences between upon wakeup and 6 hours later (p< .001) and between 1 hour later and 6 hours later (p< .05). Second, there were a significantly time-dependent ranges of fundamental frequencies of participants by hour (F=3.130). According to the results of the LSD analysis the significant differences in range of fundamental frequencies were found between upon wakeup and 1 hour later and also between wakeup and 6 hours later (p< .05). The results above indicate that vocal fold movements upon wakeup is different from those of several hours later.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.119-125
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• 2011

Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.261-264
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• 2007

Five males trained singers (age:25.0${\pm}$1.4years, career:6.8${\pm}$1.1 years) and five female trained singers (age:22.0${\pm}$1.0years, career:5.8${\pm}$1.2 years) participated in this study. SaO2(Oxi Hemoglobin saturation) measured by Oxy-Pulse meter and PAC02 (Pressure Alveolar Co2) measured by Quick et CO2 are compared with pre and post vocal training. As the result, PAC02 was lower than normal range (36-40mmHg) after vocal training, leading to Hypocapnia. This causes headache and dizziness

• The Journal of the Acoustical Society of Korea
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• v.31 no.3
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• pp.197-204
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• 2012

In this thesis, studied the method to minimize the changes in frequency response and level due to the variation of the distance from the source to the microphone. selecting three microphones (omni directional, cardioid, super cardioid) which are being used generally, frequency responses were measured in accordance with the distance changes. Gotten the difference from the reference as the result of measurement, changed responses for each frequency range were compensated in comparison of the original human vocal source. In low frequency range, the low frequency boost caused by the proximity effect and decrease in accordance with the distance were compensated. The variation in mid-frequency range is comparatively small, however since the mid-range is the most important part of the human vocal signal, were compensated the mid-frequency range in comparison of the reference. The human vocal signal variation in high frequency range is extremely small and the high frequency is compensated close to the original source without difficulty. Understanding the microphone characteristics and compensations, this study showed that the response can be maintain among the change of the distance from the source to the microphone.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.25-29
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• 2016

Background and Objectives : The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. Materials and Methods : from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. Results : Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense$^{(R)}$, Radiessess$^{(R)}$, and Rofilan$^{(R)}$ were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. Conclusion : IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.

• Phonetics and Speech Sciences
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• v.10 no.4
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• pp.135-146
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• 2018

The Modified Voiced Lip Trill (MVoLT) training is a variant of voiced lip-till training characterized by increased loudness, lowered laryngeal position, and lip contact facilitated with fingers. The purpose of the current study was to assess the effect of the MVoLT training program on vocal changes of musical singing theater students. A total of 32 musical theater students (17 males and 15 females, age ranging from 18 to 29) participated in the study. For about three months, each participant was tutored using a systematic program focussing on the MVoLT training, accompanied by certain facilitating strategies. Pre- & post-training multi-dimensional vocal characteristics were assesed and compared. Results showed that cepstral peak prominence during vowel phonation increased after training, while its standard deviation and Cepstral Spectral Index of Dysphonia decreased. When an aerodynamic assessment was performed, maximum phonation time, subglottal pressure, mean airflow rate increased, while electroglottographic measures did not change. In addition, decreased psychometric measures, higher maximum pitch, and increased vocal range were noted after training. In conclusion, the MVoLT was proven to have a potential as an effective and safe training method for musical theater singing.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.16-20
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• 2004

Purpose : To assess perceptual, acoustic and aerodynamic measure of voice quality in patients with unilateral vocal cord paralysis before and after type I thyroplasty. Methods : The clinical records of patients operated type I thyroplasty in the Departement of otorhinoalryngolgy, Yongdong Severance hospital from November 2001 to November 2003 were reviewed. All patients uderwent a vocal function evaluation including perceptual, acoustic and aerodynamic measures of voice preoperative and on $60^{th}$ postoperative day. The perceptual and acoustic measures were obtained from recording of patients' reading a 'Sanchak' passage. The perceptual evaluation was performed by 2 speech pathologist using a 4-point rating scale. Acoustic parameters(voice range profile low(RAL), voice range profile high(RAH), average fundamental frequency(AFX), closed quotient, harmonic to noise ratio, jitter and shimmer) were investigated by Lx speech studio. Mean flow rate(MFR), subglottic pressure(Psub) and intensity were measured using the Phonatory function analyzer. The maximum phonation time was also measured. The data were statistically analyzed. A paired t-test (p<0.1) was used to compare preoperative and postoperative results. And multiple regression test was used to find which parameter was most correlated to improvement of postoperative voice quality. Results : Among aerodynamic parameters, Psub $(88.11mmH_2O{\rightarrow}58.7mmH_2O)$, MPT(7.87sec${\rightarrow}$12.53sec), MFR (359.8ml/sec${\rightarrow}$161.06ml/sec) were statistically improved. AFx(205.5Hz${\rightarrow}$163.27Hz), AQx(23.9%${\rightarrow}$48.3%), RAL, RAH. Jotter and shimmer were improved. In multiple regression test, AFx and AQx was noted as the two meost correlated parameters to improvement of postoperative breathiness. But general grade of voice quality was more correlated to Psub and shimmer. Conclusion : Vocal fold medialization procedures effectively reduce glottic gap. Increasing of contact area of both vocal folds induced improvement in aerodynamic parameters and leaded stabilizing of vocal fold vibration. That effect results in improvement in acoustic parameters (shimmer, jitter, signal-to-noise ratio, voice range profile) and voice quality.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.1
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• pp.11-16
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• 2001

Background and Objectives : A burn injury to the glottis differs from a burn injury to the trachea, bronchi, and lung parenchyma, in that thermal injury does not occur to any significant degree below the level of the larynx, due to the effective cooling of air by the upper airway and to reflex closure of the vocal cords from a blast of hot air. Therefore, the laryngeal inhalation injury give rise to airway problem and voice change. The objectives of this study is to assess management of laryngeal inhalation injury and voice change after management. Materials and Methods : Voice choses and laryngeal injuries of eight laryngeal inhalation patients were analyzed through questionnaire, voice dynamic laboratory, and laryngeal stroboscopy. Operative management was performed to five patients for airway patiency and vocal cord movement on laryngeal pathology ind voice therapy was performed to all patients. One-year after, voice changes and laryngeal injuries were reanalyzed with same methods. Results : Vocal breathiness, decreased voice intensity, reduced voice range, and easy fatigability were major complaints of laryngeal inhalation patients. Glottic stenosis were developed to five of eight patients, and vocal cord atrophy, bowing were developed to others. Vocal cord mucosal waves were significantly decreased in all patients. Jitter(%), Shimmer(dB) were increased and Maximal phonation time(MPT) was decreased. One-year after, subjective voice changes and objective voice parameters were improved. And vocal cord mucosal waves were recovered in all patients. Conclusions : Subjective voice quality and objective voice parameters were improved after operative management for laryngeal pathology and voice therapy. And we observed recovery of vocal fold mucosal waves by laryngeal stroboscopy. We think that early preventable tracheotomy is necessary to reduce the laryngeal contact injury in laryngeal inhalation patients.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.143-145
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• 2007

Muscle groups that are located in and around the vocal tract can produce audible changes in frequency and/or intensity of the voice. Vocal vibrato is a characteristic feature in the singing of performers trained in the western classical tradition and vibrato is generally considered to result from modulation in frequency amplitude and timbre. Vocal tremor is also characterized by periodic fluctuations in the voice frequency or intensity and vocal tremor is symptom of a neurological disease as Spasmodic dysphonia , Parkinson's disease. Vocal vibrato and Vocal tremor may have many of the same origins and mechanisms in the voice production systems. The purpose of this study is to find acostic character of Korean traditional song Pansori singer's vibrato and Spasmodic dysphonia patient's vocal tremor. twelve Pansori singers and seven Spasmodic dysponia patients participated to this study. Power spectrum and Real time Spectrogram are used to analyze the acoustic characteristics of Pansori singing and Spasmodic dysphonia patient's voice The results are as follows; First, vowel formant differences between Pansori singing and Spasmodic dysphonia patient's voice are higher F1, F3. Second, The vibrato rate show differences between Pansori singing and Spasmodic dysphonia patients;$4^{\sim}6/sec$ and $5{\sim}6/sec$ Vibrato rate of pitch is 5.7 Hz ${\sim}$ 42.4 Hz for Pansori singing , 3.8 Hz ${\sim}$ 27.9 Hz for Spasmodic dysphonia patients ;Vibrato rate of intensity range is 0.07 dB ${\sim}$ 8.26 dB for Pansori singing and 0.07 dB ${\sim}$ 4.81 dB for Spasmodic dysphonia patients