• 대한후두음성언어의학회지
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• 제18권2호
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• pp.122-128
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• 2007

This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

• 대한후두음성언어의학회지
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• 제24권1호
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• pp.47-50
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• 2013

Background and Objectives:The purpose of this study is to find features in acoustics and to learn useful features of parameters in order to distinguish laryngeal diseases through many acoustic variables. Materials and Methods:The subjects of this study were 125-male patients who had been diagnosed with vocal nodule, vocal polyp, vocal cyst, Reinke's edema, leukoplakia. To research the features of each disease in acoustics, they are measured 34 parameters by using MDVP. Results:It is clear that in order to see a meaning result when distinguishing laryngeal diseases, $F_0$, $MF_0$, $T_0$, Fhi, Flo, PER variables are significant (p<.05). It means that variables related to fundamental frequency are important to anticipate which group will be diagnosed with Reinke's edema and leukoplakia. vAm had an effect on getting a significant result in terms of amplitude perturbation parameters, which is useful to distinguish between laryngeal polyp/cyst and other laryngeal disease (p<.05). ATRI made a significant result in related to tremor parameters, which is useful to distinguish between laryngeal polyp and other laryngeal disease (p<.05). Conclusion:$F_0$, $MF_0$, $T_0$, Fhi, Flo, PER, vAm, ATRI might be meaningful parameters distinguishing pathologic from benign laryngeal diseases. Especially, the vAm and ATRI are an important factor when forecasting which group would be diagnosed with vocal polyp.

• 말소리와 음성과학
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• 제8권2호
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• pp.57-63
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• 2016

Recently, the Lax Vox voice therapy has been used as one of the SOVTE(Semi-Occluded Vocal Tracts Exercise). The purpose of this study was to explore the effect of Lax Vox voice therapy for a patient with Spasmodic dysphonia on voice improvement. One female spasmodic dysphonia patient(age=27) who had been diagnosed by a laryngologist received Lax Vox voice therapy. The Lax Vox protocol was configured as 5 steps (1 warm-up and 4 steps : bubbling without / with phonation/ gliding with phonation/ generalization) in this study. A total of 11 sessions were performed by a certified speech language pathologist. The present study evaluated the acoustic, aerodynamic, auditory perceptual, and patient's self-rating between pre-, mid-, and post- voice therapy. All objective and subjective parameters were improved after voice therapy; Reduced frequency variation, increased maximum phonation time, enlarged voice range, improved 'G' and 'S' in GRBAS & USDRS, and reduced VHI were observed. Especially, decreased $f_0$ and remarkably reduced voice tremor were also demonstrated following Lax Vox voice therapy. Accordingly, Lax Vox voice therapy technique can be useful for improving voice and quality of life in patients with spasmodic dysphonia.

• 한국산학기술학회논문지
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• 제13권7호
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• pp.3048-3056
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• 2012

본 연구의 목적은 교사 및 성악가에 대한 음성장애지수(VHI), 음성관련 삶의 질 평가(V-RQOL), 음향음성학적 평가에 대한 특성을 연구하였다. 본 연구는 56명(성대결절이 있는 교사 20명 및 성악가, 그리고 정상화자 16명)을 대상으로 하였다. 모든 대상자에게 VHI, V-RQOL를 평가하였고, 음향학적 평가는 CSL 4500(Kay Pantax, USA)으로 측정하였다. 21명의 대상자에게 VHI, VRQOL, CSL을 이용한 음향적 평가에 대한 검사-재검사를 위해 두 번 실시하였다. 본 연구의 자료처리는 SPSS 18.0(SPSS Inc, Chicago, IL)을 사용하였다. 본 실험 결과, VHI 및 V-RQOL 결과, 교사 및 성악가 집단의 신체적, 기능적, 정서적 점수가 정상집단에 비해 유의하게 높았다(p<0.05). 음향학적 특성은 기본주파수 관련 변수, 기본주파수 변이 관련 변수, 음성강도 변이 관련 변수, 잡음 관련 변수, 진전 관련 변수) 범주에서 실험집단이 정상집단에 비해 유의하게 높았다(p<0.05). 결론적으로 교사 및 성악가들은 신체-기능영역에서 자신의 음성문제를 심각하게 인식하는 것 같다.

• 대한후두음성언어의학회지
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• 제21권1호
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• pp.22-26
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• 2010

Neuromuscular Disorders Affecting the Larynx are steadily important topics at laryngology. Physiology of larynx is controlled by the frame structure and neuromuscular dynamics to acting on the specialized soft tissue, Therefore, for a proper understanding of the larynx, it is needed the voice and swallowing, a series of prayers on the regulation of neurologic function and the correlation between systemic neuromuscular disease and laryngeal symptoms and clinical knowledge, We described that clinical findings and treatments of the 3 neurological diseases causing dysphonia well (Parkinson's disease, laryngeal tremor, spasmodic dysphonia) and vocal impairments for stoke patients.

• 한국산학기술학회논문지
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• 제14권7호
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• pp.3218-3222
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• 2013

판소리는 우리나라 전통 성악곡이며 소리, 대화, 몸짓이 어울린 종합 예술로 독창성과 우수성을 세계적으로 인정받은 세계무형유산이다. 특히, 판소리는 소리꾼의 해학적 표현과 청중의 참여도가 높은 점에서 예술적 가치가 있으며 모든 계층이 두루 즐기는 예술로서 사회적 통합의 기능을 담당한 것으로 평가되고 있다. 따라서 본 논문에서는 사회와 시대를 표현한 판소리의 음향학적 특징을 분석하기 위해 판소리 다섯 마당을 대상으로 음성신호 분석 기술을 적용한 상관성 추출 연구를 수행하였다. 이를 위해 판소리 다섯 마당에 대한 스펙트로그램, 피치, 안정도 및 강도 분석을 실험하였다. 실험 결과를 통해 판소리는 청중들에게 집중과 흥미를 지속적으로 유지시키면서 이야기를 풀어가는 특징을 잘 반영하기 위해 목소리의 파동 및 성대 떨림의 변화 폭이 크고 안정적이며 음성 에너지가 큰 소리로 표현하고 있는 것으로 분석되었다.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 2002년도 제16회 학술대회
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• pp.75-82
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• 2002

Botulinum toxin-A, a neurotoxin derived from Clostridia Botulinum, has been injected into the laryngeal muscle(s) for the treatment of the spasmodic dysphonia at the Voice Clinic, Yonsei Institute of Logopedics and phoniatrics since December 1995. We analyzed 355 patients with spasmodic dysphonia, using Botox register review. In the 355 patients, female is 86.8%. male is 13.2%. 305 patients (85.9%) had adductor type of spasmodic dysphonia and 35 patients (9.9%) were vocal tremor type and 15 patients were abduction and mixed type. Botulinum toxin type-A (Botox) injection using EMG was most frequently conducted as 587 cases, comparing with flexible nasopharyngoscopy gudied injection (68cases) and tele- laryn-goscopy guided injection (31cases). In the respect of frequency of Botox injection, 137 patients(38.6%) were injected one time but 1 patient was injected 17times. The mean dose of Botox is 6.2U. Clinically, initial dose of Botulinum toxin-A was high dose (7-8U) but current dose is small dose (3U). And the mean duration of Botox injection is 6.4 month. In conclusion, to optimize effect of the treatment for spasmodic dysphonia, Botulinum toxin-A injection is combined with voice therapy.