• Phonetics and Speech Sciences
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• v.4 no.4
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• pp.95-107
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• 2012

As BTX-A, which has been known to be the most effective treatment for ADSD, is not effective in treating vocal tremors, voice assessment must be employed to perform differential diagnosis of SD and vocal tremor in an accurate fashion. In this study, the characteristics of vocal changes after botulinum toxin injection were compared by analyzing the voice characteristics resulting from the presence of vocal tremors using objective analysis devices, with the aim of helping to provide prognoses and to determine remedial effects in clinical cases comprising patients with adductor spasmodic dysphonia accompanied by voice tremors. Respiratory function tests, aerodynamic analysis, electroglottography (EGG), acoustic analysis, auditory perception tests, and K-VHI had been conducted at intervals of four, eight, and twelve weeks before and after injection, targeting a group of 17 ADSD female patients (a ADSD group of four with vocal tremor and a ADSD group of 13 without voice tremor). For average FVC and FEV1, the T group showed statistically significant low averages compared with the NT group, whereas the T group showed statistically significant high average ATRI compared with the NT group. In addition, the T group showed a statistically significant Fatr, lower than that of the NT group. For the ADSD group of patients with voice tremor, their vocal tremor remained unchanged despite noticeable decrease in wringing voices. In other words, as the vocal tremor and wringing voices are two distinctive features, there is a need for the two features to be targeted separately for differential diagnosis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.9-14
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• 2021

Spasmodic dysphonia, essential tremor, and vocal tremor related with Parkinson's disease are different disorders showing fairly similar symptoms such as difficulty in the speech onset, and tremble in the voice. However, the cause and the resulting treatment of these diseases are different. Spasmodic dysphonia is a vocal disorder characterized by spasms of the laryngeal muscles during a speech, invoking broken, tense, forced, and strangled voice patterns. Such difficult-to-treat dysphonia disease is classified as central-origin-focal dystonia, of a yet unknown etiology. Its symptoms arise because of intermittent and involuntary muscle contractions during speech. Essential tremor, on the other hand, is characterized by a rhythmic laryngeal movement, resulting in alterations of rhythmic pitch and loudness during speech or even at rest. Severe cases of tremor may cause speech breaks like those of adductor spasmodic dysphonia. In the case of hyper-functional tension of vocal folds and accompanying tremors, it is necessary to distinguish these disorders from muscular dysfunction. A diversified assessment through the performance of specific speech tasks and a thorough understanding for the identification of the disorder is necessary for accurate diagnosis and effective treatment of patients with vocal tremors.

• 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

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.82-85
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• 2014

Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

• The Journal of Internal Korean Medicine
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• v.27 no.3
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• pp.776-783
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• 2006

Tremor is a rhythmic and involuntary muscular contraction characterized by oscillations of a part of the body. The most common of all involuntary movements, tremor can affect various body parts such as hands, head, facial structures, vocal cords, trunk, and legs; most tremors, however, occur in the hands. Clinically, tremor is classified into postural tremor, resting tremor, action tremor, and other kinds of tremor, and treated according to the causes. The author reports the improvement of the patient, hospitalized at Dong Seo Medical Center, whose tremor was not classified specifically in western medicine but was diagnosed as Ganhyeolbujok (肝血不足) by Korean medicine.

• Journal of Haehwa Medicine
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• v.16 no.2
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• pp.281-288
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• 2007

Tremor is a rhythmic, involuntary muscular contraction characterized by oscillations (to-and-fro movements) of a part of the body. Essential tremor is a 6-8 Hz tremor that is of variable amplitude. It is aggravated by posture and movement and relieved by rest and alcohol. Most affected part are the arms, head and vocal apparatus. The purpose of this study is to show a case of tremor patient with essential tremor improved by oriental medical treatment. The patient was 71-year-old woman who featured essential tremor and at the same time complained general body weakness, nausea, and anorexia. She was treated by oriental medicine with acupuncture, herb medication, and Korean psychotherapy; Eejeong-byunki, Jiun-goron. The features of essential tremor was reduced after taking oriental medical therapy. This result suggested that the oriental medical therapy can be effective for treating essential tremor.

• Journal of Oriental Neuropsychiatry
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• v.16 no.2
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• pp.267-276
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• 2005

Tremor is a rhythmic, involuntary muscular contraction characterized by oscillations(to-and-fro movements) of a part of the body. The most common of all involuntary movements, tremor can affect various body parts such as the hands, head, facial structures, vocal cords, trunk, and legs; most tremors, however, occur in the hands. Tremor often accompanies neurological disorders associated with aging. Although the disorder is not life-threatening, it can be responsible for functional disability and social embarrassment. The clinical study was carried out the 4 patients with tremor who were treated in Dong Seo Medical Center from 1 January 2005 to 31 August. The results were summarized as follows. Tremor has relation to liver according to Jangbu theory. So we performed acupuncture treatment(Ganseonggyeok) and Herbal medication on tremor. After our treatments, tremor and some other symptoms were improved.

• 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.

• Speech Sciences
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• v.8 no.3
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• pp.173-184
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• 2001

The purpose of this study was to examine the effects of manipulating loudness and pitch in terms of speech intelligibility and voice of a patient with Parkinson's Disease. The subject, who was diagnosed as a patient with Parkinson's disease 11 years ago, demonstrated a severely breath voice with low intensity. The accuracy of articulation in consonants was intelligible only at the single word level, and the overall intelligibility in continuous speech was low. The results showed that the subject's articulation accuracy and speech intelligibility was significantly improved after having loudness and pitch training. Habitual Fo, Jitter, Shimmer, Fo tremor, Amp tremor were decreased after training. In addition, the value of HNR also increased after training. It was shown that the changes of these acoustic parameters were closely related to the decrease of breathiness in Parkinson's voice, and this decrease of breathiness affected speech intelligibility considerably. Based on the experimental results, it was claimed that the vocal training by manipulating the loudness and pitch could be highly effective in improving the voice quality and speech intelligibility in Parkinson's Disease.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.12-14
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• 2019

Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.