• 대한후두음성언어의학회지
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• 제8권2호
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• pp.178-184
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• 1997

Vocal nodule due to vocal hyperfunction is one of the representative chronic diseases of vocal folds, and it can be cured by surgical movement, and/or voice therapy. The present study is, focusing on the latter, to compare the acoustic and aerodynamic results of the pretreatment with those of posttreatment, and then to investigate the objective date on the efficiency of the voice therapy for the patients with vocal nodules. 11 females(age : 7-49) and 5 males(age : 8-40), total 16 patients wi vocal nodules treated by voice therapy were participated as subjects. Six measurements and comparisons of pretreatment and posttreatment of the results were performed : litter, shimmer, and noise-to-harmonic ratio as acoustic analyses ; maximum phonation time, mean flow rate, and the subtraction of mean flow rate from maximum flow rate as aerodynamic analyses. As a result, 14 of 16 subjects showed improvement at more than 4 of 6 measurements, and in group data, every measurements of posttreatment was improved significantly than the pretreatment. On the whole, the improvement of aerodynamic aspects was more statistically significant than that of acoustic ones.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.107-110
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• 2006

Background and Objeetives : There are few studies reported that specifically examined the voice onset time(VOT) in patients with bilateral vocal nodules. The purpose of this study was to study the characteristics of voice onset in patients with bilateral vocal nodules. Materials and Methods : 52 female patients with bilateral vocal nodules were examined, aged from 20 to 54 years, and were compared with 25 normal female control group. All subjects produced five repetitions of the voiceless stops $/p^h,\;t^h\;k^h/$ in vowel context /ai_a/. VOT was measured by the time between the release of the stops and the onset of voicing. Results : VOTs of the voiceless stops $/p^h/\;and\;/t^h/$ in patients with bilateral vocal nodules were significantly shorter than those of normal subjects. VOT of the $/k^h/$ in them was shorter than those of normals, but the difference was not significant. This results showed that VOTs of the voiceless stops in patients with bilateral vocal nodules were shorter than those of normal subjects. Conclusion : The rapid onset of voicing in patients with bilateral vocal nodules might be associated with increased laryngeal muscle tension by hard glottal attacks. We suggest that VOT can be a clinically useful acoustic parameter for evaluating voice in patients with bilateral vocal nodules.

• 말소리와 음성과학
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• 제3권3호
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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.

• 대한후두음성언어의학회지
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• 제13권1호
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• pp.33-39
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• 2002

Background and Objectives : The vocal fold nodules which were made by excessive contact or vibration of the vocal folds were classified to the soft nodule and the hard nodule in according to the hardness or the duration of nodule. Sometimes laryngologist saw the nodule to be located in different level. Authors thought that each nodule to be located in different level might have the different causes. Therefore we studied to know the relationship between the voicing technique and each vocal fold nodule to be located in different level. Materials and Methods : One-hundred forty nine patients who had the vocal fold nodule were evaluated. Sites and shapes of the vocal fold nodules were investigated using videostroboscopy. Videokymography was also used to scan the center of the vocal fold nodules during phonation and classified to several types. Same procedures were done on normal subject while he simulated the various types of voicing. And we compared the findings between both of them. Three different types of lesion can be distinguished. These are ML group that lesions were located from mid to low, MH group that lesions were located from mid to upper and HL group that lesions were located from lower to upper of the vocal folds. Results : The VKG findings of ML group and situation simulating with hard glottal attack and vocal fry were similar. MH group had a similar VKG findings with situation simulating with whispering or high pitch voicing. HL group had a similar VKG findings with situation simulating with loud voicing. Conclusions : Authors thought that each vocal fold nodule, which had different shapes and located in different level, related with the different types of voicing.

• 한국콘텐츠학회논문지
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• 제18권1호
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• pp.108-116
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• 2018

본 연구의 목적은 정상 집단과 성대결절 집단의 음성을 음향학적 측정(AVQI), 청지각적 평가(GRBAS, CAPE-V)를 수행하여 그 차이와 상관관계를 조사하는 것이다. 이를 위해 성대결절 환자 335명의 음성 샘플을 음향학적으로 분석하고, 3명의 평가자를 통해서 청지각적 평가를 실시하였다. 연구결과, 정상 집단의 AVQI, grade(G), overall severity(OS) 점수는 성대결절 집단의 점수보다 낮게 평가되었다. 청지각적 척도간의 상관관계에서는 GRBAS의 G 척도와 CAPE-V의 OS 척도는 상관관계가 높은 것으로 나타났고, 음향학적 측정 AVQI와 G, OS 간의 상관관계도 높은 것으로 확인되었다. 두 집단 간의 AVQI, G, OS를 감별하는 역치값은 각각 ${\leq}4.06$, ${\leq}1$, ${\leq}26$ 였으며, 예측진단력은 0.840, 0.860,0.848이었다. 결론적으로 AVQI와 청지각적 평가를 통하여 성대결절 음성에 대한 선별 가능성을 높일 수 있고, 음성장애의 진단 및 치료 계획수립에 도움을 줄 것으로 사료된다.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.133-137
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• 2006

Objectives : The purpose of this paper is to know the efficacy of voice therapy for vocal fold nodules in children. Materials and Methods : Sixty two patients with vocal nodules(46 boys and 16 girls) were retrospectively reviewed. Age ranged from 4 to 15 years with mean age of 8 years. Questionnaire survey was carried out with voice handicap index, at pretherapy and post-therapy(3 months and 5 years after voice therapy). Results : Sixty two percent of the patients showed improvement by voice therapy. Twenty five patients continued education at home after voice therapy, but only eight childrens were included this group in pre-school aged children. Voice handicap index was improved in 3 months and 5 years after voice therapy. In contrast, pre-school children group showed slight aggravation in 5 years, especially in emotional subdomain. Conclusion : Voice therapy is effective primary treatment in children with vocal fold nodules. Different result between preschool aged children and school aged group shows needs for age specific approach of voice therapy.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.112-117
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• 2004

Background and Objectives : This study is purposed to investigate the statistically significant discrimination model for predicting vocal fold nodule and polyp's lesional grade, with patients' background data and objective voice evaluation parameters. Materials and Method : The retrospective research was carried out at the Ewha Womans University Hospital. 122 patients' voice examination data had been selected, and lesion screening (Grade I, II, and III) was conducted by 2 ENT specialists, with each patient's vocal fold pictures achieved during the laryngoscopy examination. Results : The Lesional Grade Discrimination Model with which the lesional grade of vocal fold nodules and polyps could be predicted was derived by the ordinal logistic regression analysis (using SPSS 10.0). With this model the lesional grades of 73 out of 122 patients(59.8%) were correctly predicted to their formerly screened ones. Conclusion : This model applied the multivariate approach, which statistically combined these currently used parameters, Jitter, Shimmer, MFR, MPT, and patient's background data such as gender and dysphonia period. It might explain the status of benign lesion of vocal folds, and furthermore expect the physiological function of vocal folds.

• 음성과학
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• 제11권4호
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• pp.101-120
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• 2004

Vocal nodule is one of the representative chronic diseases of vocal folds, and it can be cured by voice therapy. However, the existing therapeutic methods about vocal nodule are in great demand. The purpose of this study was to evaluate the effect of therapeutic methods between Accent method and SK-MVTT (Seong-Tae Kim's multiple voice therapy technique), which was designed by the author. We identified 40 females, who diagnosed having vocal nodules, aged from 21 to 52 years (mean age: 40 years). Twenty females were treated by the SK-MVTT and the other 20 females the Accent method. All subjects received 12 sessions of treatment, and were evaluated after finishing the 6th and the 12th session. The results showed that the SK-MVTT produced a better results compared to the Accent method. The SK-MVTT was better especially at the initial stage of voice therapy compared to the Accent method. In this study, we can suggest that SK-MVTT may be useful in improving the voice qualities of vocal nodule patients. However, more data should be collected and evaluated before it can widely be used in other clinics.

• 대한후두음성언어의학회지
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• 제13권1호
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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.

• 말소리와 음성과학
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• 제10권4호
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• pp.155-161
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• 2018

The purpose of this study was to evaluate the efficacy of a multiple voice therapy technique ($SKMVTT^{(R)}$) using laughter for the treatment of various benign vocal fold lesions. To achieve this, 23 female patients diagnosed with vocal nodules, vocal polyp, and muscle tension dysphonia through videostroboscopy were enrolled in vocal hygiene and $SKMVTT^{(R)}$. All of the patients were treated once a week for 4 to 12 sessions. The GRBAS scale was used to confirm the changes in voice quality before and after the treatment. Acoustic analysis was performed to evaluate jitter, shimmer, NHR, fundamental frequency variation, amplitude variation, PFR, and dB range. Videostroboscopy was performed to confirm the changes in the laryngeal features before and after the treatment. After the $SKMVTT^{(R)}$, the results of the perceptual evaluation demonstrated that the G, R, and B scales significantly improved. An acoustic evaluation also demonstrated that jitter, shimmer, NHR, vAm, vFo, PFR, and dB range also significantly improved after the $SKMVTT^{(R)}$. In comparison to the videostroboscopic findings, the size of the vocal nodules and vocal polyp decreased or disappeared after the treatment. In addition, the size of the cuneiform tubercles decreased, the length of the aryepiglottic folds became longer, and the laryngeal findings of the supraglottic compressions improved after the $SKMVTT^{(R)}$. These results suggest that the $SKMVTT^{(R)}$ is effective in improving the vocal quality of patients with benign vocal fold lesions. In conclusion, it seems that laughter and inspiratory phonation suppressed abnormal laryngeal elevation and lowered laryngeal height, which seems to have the effect of improving hyperfunctional phonation.