• Phonetics and Speech Sciences
• /
• v.9 no.4
• /
• pp.99-106
• /
• 2017

Clinical data about vocal nodules have seldom been reported, even though vocal nodules are commonly diagnosed in outpatient speech and voice clinic. This study aims to investigate clinical characteristics of the patients who are diagnosed with vocal nodules. This study analyzed the data for 10 years from the 319 patients diagnosed with vocal nodules (45 males and 274 females with the mean age of 39.4 ranging from 2 to 83) in terms of gender, age, occupation, voice change initiation pattern, change with time, throat clearing, smoking history, type of voice abuse, acoustic analysis, maximum phonation time, GRBAS, and VHI. Thirteen patients (4.08%) had unilateral vocal nodule and 306 patients (95.9%) had bilateral vocal nodule, the majority of which had a pattern of asymmetry (73.9%). The glottal closure pattern was hourglass in 72.1% of patients, posterior chink in 17.9% of patients, and irregular in 7.9% of patients. The most common occupational category was professional voice users (43.4%). The voice abuse pattern included excessive talking in 96 patients (76.8%), loud voice in 78 (62.4%) patients, and excessive singing in 17 patients (21.6%). The patients showed worse scores in G, B, and S than in R and A for the GRBAS evaluation. The most recommended treatment for vocal nodules was voice therapy. The current clinical data will be helpful for treatment planning for the patients of vocal nodule.

• Phonetics and Speech Sciences
• /
• v.3 no.1
• /
• pp.97-102
• /
• 2011

Electroglottography (EGG) is a common method for providing non-invasive measurements of glottal activity. EGG has been used in vocal pathology as a clinical or research tool to measure vocal fold contact. This paper presents the results of pitch, jitter, and closed quotient (CQ) measurements in electroglottographic signals of young (mean = 22.7 years) and elderly (mean = 74.3 years) male and female subjects. The sustained corner vowels /i/, /a/, and /u/ were measured at around 70 dB SPL since the most notable among EGG variables is the phonation intensity, which showed positive correlation with closed phase. The aim of this paper was to measure EGG data according to age and gender. In CQ, there was a significant difference between young and elderly female subjects while there was no significant difference between young and elderly male subjects. The mean value for young males was higher than that for elderly males while the mean value for young females was lower than that for elderly females. Thus, it can be said that in mean values, increased CQ was related to decreased age for females, while CQ decreased for males as the speaker's age decreased. Although the laryngeal degeneration due to increased age seems to occur to a lesser extent in females, the significant increase of CQ in elderly female voices could not be explained in terms of age-related physiological changes. In standard deviation of pitch and jitter, the mean values for young and elderly males were higher than that for young and elderly females. That is, male subjects showed higher in mean values of voice variables than female subjects. This result could be considered as a sign of vocal instability in males. It was suggested that these results may provide powerful insights into the control and regulation of normal phonation and into the detection and characterization of pathology.

• Archives of Plastic Surgery
• /
• v.39 no.1
• /
• pp.71-75
• /
• 2012

Recurrent laryngeal nerve paralysis is the most common and serious complication after thyroid cancer surgery. The objective of this study was to report the advantages of the vein wrapping technique for nerve reconstruction in patients with thyroid cancer invading the recurrent laryngeal nerve and its effects on postoperative phonatory function. The subjects were three patients who underwent resection of the recurrent laryngeal nerve during surgical extirpation of papillary thyroid cancer. Free ansa cervicalis nerve graft or direct neurorrhaphy with a vein wrapping technique was used to facilitate nerve regeneration, protect the anastomosed nerve site mechanically, and prevent neuroma formation. One-year postoperative laryngoscopic examination revealed good vocal cord mobility. Maximum phonation time ($19.5{\pm}0.3$ sec) was longer than a previously-reported value in conventional reconstruction patients ($18.8{\pm}6.6$ sec). The present phonation efficiency index ($7.88{\pm}0.78$) was higher than that previously calculated in conventional reconstruction ($7.59{\pm}2.82$). The mean value of the Voice Handicap Index-10 was 6, which was within the normal range. This study demonstrates improvement in phonation indices measured 1 year after recurrent laryngeal nerve reconstruction. Our results confirm that the vein wrapping technique has theoretical advantages and could be favored over conventional reconstruction techniques for invenerate nerve injuries.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.12 no.2
• /
• pp.140-144
• /
• 2001

Backgrounds & Objectives : Prolonged hearing loss was considered as one of the factors which have the potential to cause vocal changes. However, the analysis of quality of phonation in hearing loss patients has not been achieved enough. The purpose of the study was to evaluate the difference in objective acoustic parameters between long-term hearing impaired patients and normal control group. Material & Methods : The material of this investigation comprised a group of 20 patients (M : F=10 : 10) with moderate or profound hearing loss(over 50dB). The duration of all hearing loss was over 1 year. All of them underwent the acoustic examinations comprising electroglottography, multidimensional voice program and formant analysis during phonation of the bowels /a/ with free confortable tone and /i/ with voluntary high tone. The results of the acoustic examinations were compared with those of a control group, composed of 20 sex- and age-matched normal hearing subjects. Results : In the male hearing loss subjects, the significant increase was detected in pitch and shimmer during phonation of /a/ and in pitch during phonation of /i/. In addition, this group was characterized by decreased fundamental frequency during phonation of /i/. In female, there was no difference between hearing loss group and normal control group except a decreased formant 1 frequency. Conclusion : Long-term moderate and profound sensorineural hearing loss could affect the objective voice parameters.

• Phonetics and Speech Sciences
• /
• v.9 no.4
• /
• pp.107-114
• /
• 2017

The purpose of the current study was to compare selected acoustic and electroglottographic measures (closed quotient, pitch, and loudness) among vowel phonation, traditional voiced lip trill ($VLT_T$), modified voiced lip trill methods ($VLT_M$). A total of 21 participants without voice complaints produced 4-second long samples using each phonation method. Results indicated that mean closed quotient of $VLT_M$ was higher than that of vowel phonation and $VLT_T$, while its range and standard deviation measures were higher than those of vowel phonation. Mean, range, standard deviation, maximum of pitch measures of $VLT_M$ were higher than those of vowel phonation. Lastly, mean and maximum loudness of the $VLT_M$ were higher than $VLT_T$. In conclusion, the current data indicate the possibility to use the $VLT_M$ as a training method for singing or a strategy to facilitate generalization effect of voice therapy. Current results also reflect the necessity for further study pertaining to the long-term effect of the $VLT_M$ training method. Clinical implications are discussed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.26 no.2
• /
• pp.112-116
• /
• 2015

Background and Objectives : Aerodynamic analysis is an examination which provides information regarding various vocalization measures indicating laryngeal efficiency. Voice evaluation using such examination must be capable of distinguishing between normal to abnormal voice. It also observes variables on aerodynamic characteristics by gender in regards to patients of vocal disorders, especially of vocal cord paralysis and vocal polyp, and compares the conditions before and after surgery. This paper therefore, seeks to build a framework for establishing standard levels of aerodynamical characteristic on vocal disorders. Subjects and Methods : The study was intended for a total number of 20 patients with vocal polyp or unilateral vocal cord paralysis. Those with the vocal polyp underwent laryngomycroscopy surgery and the vocal cord paralysis, vocal fold injection using Restylane. Aerodynamic analysis fulfilled the Maximum sustained Phonation (MXPH) and Voicing Efficiency (VOEF) by using PAS Model 6600 (KayPENTAX, USA). Results : In MXPH, increase in PHOT were evident with vocal polyp after surgery. As for patients with vocal cord paralysis, MAXDB, MEADB, DHODB, PHOT all have increased and MEAP, PEF, MEAF decreased after surgery. In VOEF, patients with vocal cord paralysis who underwent surgery showed increase in MAXDB, MEADB, DHODB, FET100, ARES, but decreases in PEF, TARF. Conclusion : Overall, it can be concluded that patients with the vocal polyp and vocal cord paralysis seemed to get closer to the normal values after than before surgery in majority of measures. This confirms that the function of their vocal cord has improved nearly to normality through operations.

• Phonetics and Speech Sciences
• /
• v.3 no.4
• /
• pp.103-108
• /
• 2011

The purpose of this study was to investigate the effects of the Bel canto singing technique on voice quality in patients with vocal bowing and sulcus vocalis. Five patients with vocal bowing, and five patients with sulcus vocalis participated in the study. Each subject was assessed acoustically (Jitter, Shimmer, NNE) in the first and last session. Dr. Speech (version 4.0, Tiger-DRS) was used to compare acoustic parameters of pre- and post-treatment. The Bel canto singing technique consisted of breathing exercises, relaxation exercises, and phonation exercises. The results showed that the Bel canto singing technique tended to be effective on improving voice quality in patients with organic voice disorders.

• Speech Sciences
• /
• v.9 no.3
• /
• pp.77-86
• /
• 2002

The purpose of this study was to investigate the effects of Sea Dong-Il's technique on voice quality in patients with vocal nodules and phonasthenia (vocal fatigue). Ten patients (4 nodules and 6 vocal fatigue) participated in the study. Each subject was assessed acoustically (Fo, Jitter, Shimmer, NNE) in the first and last session. Dr. Speech (version 3.4, Tiger-DRS) was used to compare acoustic parameters of pre-and post-treatment. Sea Dong-Il's technique consisted of breathing exercise, relaxation exercise, and phonation exercise. The results were as follows: First, Sea Dong- Il's technique tended to be effective on improving voice quality in patients with phonasthenia and vocal nodules. Second, the nature of improvements were as follows: there was a significant difference between pre-and post-treatment in shimmer (p < .01) and NNE (p < .001), while there was no significant difference between pre-and post-treatment in Fo and Jitter. Finally, given the fact that the number of subjects was only 10, the jitter might have shown a significant difference if more subjects participated in the experiment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.8 no.2
• /
• pp.178-184
• /
• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.21 no.1
• /
• pp.17-21
• /
• 2010

Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,