• 대한후두음성언어의학회지
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• 제14권2호
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• pp.94-97
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• 2003

Background and Objectives : Bowing of the vocal fold, a bowed edge of the vocal fold results from various disorder causes glottic incompetence resulting in voice disorders. The results of treatment were not satisfactory even though a variety of methods of treatment were applied. The goal of this study is to evaluate of efficacy of the non-surgical, voice therapy in patients with vocal fold bowing. Materials and Method : Twenty two patients of vocal fold bowing not resulting from vocal fold palsy and sulcus vocalis were analyzed. After voice therapy and medical treatment, parameters of perceptual, acoustic, aerodynamic analysis and stroboscopic findings were compared those of pretreatment results. Results and Conclusion : Jitter, shimmer and maximal phonation time were significantly improved and subjective satisfaction was improved in 73% of patients. In the videostroboscopic examination, vocal fold gap was decreased in 27% of patents. The result of this study indicates that voice therapy alone has effect in treatment of vocal fold bowing. Voice therapy is one of the mainstay of treatment of vocal fold bowing.

• 음성과학
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• 제15권2호
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• pp.157-168
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• 2008

Vocal polyp is one of the representative chronic diseases of vocal folds, and it can be cured by voice therapy and/or laryngeal microsurgery. However, the existing therapeutic methods about vocal polyp are in great demand. The purpose of this study was to evaluate the effect of vocal improvement between laryngeal microsurgery and $SKMVTT^{(R)}$ (Seong-Tae Kim's Multiple Voice Therapy Technique), which was designed by the author. We identified 37 patients, who were diagnosed with unilateral vocal polyp, aged from 21 to 62 years(mean age: 46 years). 21 patients were treated by the $SKMVTT^{(R)}$ and the other 16 patients were only treated by the laryngeal microsurgery. All patients who were treated by the $SKMVTT^{(R)}$, received 12 sessions of treatment, and were evaluated before therapy and after finishing the 12th session. The patients who were treated by laryngeal microsurgery, were evaluated prior to and at least 8 weeks after surgery. The results showed that the $SKMVTT^{(R)}$ produced better results compared to the laryngeal microsurgery alone. The $SKMVTT^{(R)}$ produced better results, especially, at the initial stage of voice therapy compared with those of laryngeal microsurgery. In this study, we can suggest that $SKMVTT^{(R)}$ may be useful in improving the voice qualities of vocal polyp patients. However, more data should be collected and evaluated to be widely used in other clinics.

• 말소리와 음성과학
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• 제4권4호
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• pp.147-154
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• 2012

The purpose of this study is to examine the effect of voice improvement when vocal training, which relaxes the vocal contact, is applied to children with vocal nodules. Subjects included 20 5- to 12-year-old boys with vocal nodules in Otolaryngology and for whom voice therapy had been advised. The vocal therapy was conducted for 40 minutes per a week for a total of eight times. Results were evaluated by videostroboscopy, auditory-perceptual evaluation of GRBAS Scale, aerodynamic test, and acoustic analysis before and after therapy. As a result, first, the size of vocal nodules was reduced and the unstable pattern of vocal contact was improved. Glottic closure was increased and Phase symmetry was decreased during vocal vibration. Mucosal wave was increased and muscle tension of the larynx was reduced. Second, auditory-perceptual evaluation showed that subjects' overall quality of voice improved. GRBAS Scale Evaluation showed that the characteristics of the subjects' voice which were rough, breathy, and strained and breathy were reduced after therapy. Third, the measurements of acoustic parameters showed a statistically significant improvement. The fundamental frequency of the subejects' voice was increased and values of Jitter and Shimmer, NHR, [H1-H2] decreased. Fourth, the maximum phonation time of children was increased. These results imply that vocal relaxation training conducted in this study has a very positive effect to improve the voice of children with vocal nodules.

• 말소리와 음성과학
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• 제3권3호
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• pp.133-140
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• 2011

Muscle misuse dysphonia (MMD) is defined as a behavioral voice disorder resulting from inappropriate contractions of intrinsic and/or extrinsic laryngeal muscles. The purpose of this study was to investigate the effect of motor learning guided laryngeal motor control therapy (MLG-LMCT) which is designed to improve an existing LMT and further the effective voice treatment on people with muscle misuse dysphonia. Forty-six people with MMD (M:F=16:30) participated in this study. The voice samples of the participants were recorded to investigate the effect of MLG-LMCT before and after the voice therapy. Voice samples were analyzed via electro-glotto-graph (EGG). Contact quotient (CQ), speed quotient (SQ), and waveform were reported. In addition, perceptual and acoustical evaluation were conducted to determine the change of voice improvement after treatment. The experimenter massaged the tensioned muscles around the neck. In order to find more proper phonation the experimenter showed the subjects their EGG wave forms as to whether or not they are moving the vocal folds to the appropriate position. Therefore, the EGG wave forms were used as a type of visual feedback. With the wave form, the experimenter helped subjects move the vocal folds and laryngeal muscles to find more proper voice production. The sensory stimuli from the experimenter gradually faded out. A paired dependent t- test revealed that there was significant differences in CQ between pre- and post-therapy. Perceptually, overall, rough, breathy, strain, and transition were significantly reduced. Acoustically, there were significant differences in Fo, jitter, shimmer, and NHR. After using MLG-LMCT, most of the subjects showed improvements in voice quality. The results from this study led us to the following conclusions: Motor learning guided laryngeal motor control therapy (MLG-LMCT) has reduces muscle misuse dysphonia. These results may occur because a visual feedback from EGG wave form can maintain the effect of the muscle tension reduction from laryngeal manual therapy. In case of people with MMD who reduced muscle tension from the therapy (LMT) but, not appropriately manipulating the location of larynx or adducting the vocal folds, MLG-LMCT might be an alternative therapy approach.

• 대한후두음성언어의학회지
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• 제9권2호
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• pp.134-141
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• 1998

Mutational falsetto is a kind of voice disorders due to the failure to acquire proper low-pitched voice during the puberty. The patients with mutational falsetto can produce the normal low-pitched voice by the surgical treatment, like the type III-thyroplasty, or the voice therapy. The present study is, focusing on the latter treatment, to consider the efficiency of voice therapy for the mutational falsetto. The 7 patients who were diagnosed as mutational falsetto by the laryngologists, and treated by the voice therapist were selected as subjects. Their voices of pretherapy and posttherapy were analyzed on the aspects of acoustics and aerodynamics. Acoustic analysis was done by the MDVP(Multidimensional Voice Program) of CSL(Computerized Speech Lab, Kay Elemetrics, Co.), and aerodynamic analysis, by the Maximum Sustained Phonation of Aerophone II(Kay Elemetrics, Co.). By these measurements, we could find that fundamental frequency(F0) was significantly lowered, on the average, 65Hz. Maximum phonation time(MPT) was increased 4.57 second, and shimmer was decreased 1.644%, respectively, and each changes was statistically significant, too. On the average, jitter was decreased 0.499%, mean flow rate(MFR) was decreased 27.71ml/sec, and NHR was increased 0.023 which was the only parameter not showing improvement. But the changes of jitter, MFR and NHR were not statistically significant.

• 대한후두음성언어의학회지
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• 제10권1호
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• pp.17-23
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• 1999

Vocal hyperfunction is considered to be the most significant characteristic in larynx disorders which is found among many patients presenting hoarseness Primarily as chief complaint. In Pusan National University Hospital, we executed the voice therapy to 28 patients being 17 female and 11 male patients who visited the Voice ＆ Speech Therapy Clinic, due to the voice disorder, and then compared and analysed the voice before and after its therapy using acoustic and aerodynamic test. The obtained results were as follows. In the analysis by the local findings, it was improved to 88% in the patients of vocal nodule, 75% in mutational falsetto, 75% in the functional dysphonia, 75% in the vocal cord palsy, 50% in the vocal polyp and 50% in dysphonia plica ventricularis. For the acoustic analysis, Fo, litter, Shimmer and NHR were measured. In the patients of mutational falsetto, Fo, Jitter and NHR were shown to be improved significantly and in the patients of vocal nodule, Shimmer was shown to be improved significantly. In the patients of vocal polyp, Fo was significantly improved. In the patients of vocal cord palsy in litter and NHH were significantly improved. In the patients of dysphonia plica ventricularis, Shimmer and NHR were significantly improved and the patients of functional dysphonia were more improved in Fo, litter and Shimmer. For the aerodynamic analysis, MPT was measured. In particular, it was shown to be improved significantly in the patients of vocal nodule, improved in the vocal polyp, vocal cord palsy, functional dysphonia patients.

• 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.

• 음성과학
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• 제8권4호
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• pp.87-98
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• 2001

Vocal nodule is one of the representative chronic diseases of vocal folds, and it can be cured by surgical removal or voice therapy. The aim of this study is to evaluate the effect of the accent method, one of the popular effective voice therapy, in the patients with vocal nodule. Authors executed the accent method in 17 patients with vocal nodule who visited the Voice & Speech Therapy Clinic, Pusan National University Hospital analysed the voice before and after treatment using the local findings, acoustic analysis and aerodynamic analysis MPT. The voice was analysed with MDVP of CSL and MPT was checked using stop watch. The parameters included Fo, Jitter, Shimmer and noise to harmonic ratio(NHR) as acoustic analysis. The results were obtained as follows. In the evaluation by the local findings, it was improved to 77% in the patients of vocal nodule. Jitter and Shimmer were shown to be improved significantly. In particular, it was shown to be improved significantly in patients with vocal nodule. As the result of this study, the improvement of aerodynamic aspect was more statistically significant than that of acoustic parameters. When I generalized the above mentioned results, we suggest that it is a useful voice therapy which can be helpful to the improvement of voice, applying the accent method to the vocal nodule patients, and there are currently many methods to be used in the voice therapy, but it is thought which the accent method is the good treatment as the alternatives of keeping the continuous medical treatment.

• 대한후두음성언어의학회지
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• 제11권2호
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• pp.146-160
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• 2000

The current study aimed to establish rationales for using three different voice therapies (resonant voice, accent method, and tongue-tip trills) by comparing the aerodynamic, and vocal fold closure characteristics under three therapies. A total of 8 male under/graduate students(tenors) participated as subjects. In order to compare aerodynamic characteristics, air flow rates and subglottal pressures were measured using Phonatory function analyzer under three therapy conditions. The characteristics of vocal fold closure patterns also were examined by comparing closed quotients(CQ) measured by Electroglottograph(EGG) under three therapy conditions. However, maximum phonation time (MPT) was measured under only resonant voice and tongue-tip trills using Aerophone II. The results are summarized as follows : 1) CQ, subglottal pressure and MPT decreased significantly under resonant voice as compared with throat voice, but the air flow rate increased significantly under resonant voice. 2) CQ decreased significantly under accent method as compared with throat voice, but both air flow rate and subglottal pressure increased significantly under accent method. 3) Both CQ and MPT decreased significantly under tongue tip trills as compared with throat voice, but air flow rate and subglottal pressure increased significantly under tongue-tip trills. Clinical implications of results were discussed in light of differential effects of three voice therapies.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.39-45
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• 2000

Background and Objectives : Accent method is one of holistic approaches for behavior readjustment of voice therapy The aim of this study is to evaluate the efficacy of the accent method of voice therapy for the patients who have no improvement after LMS. Materials and Methods : Of the patients who had been undergone LMS during the period from Jan. 1999 to Dec. 1999, medical records of 38 patients who had not been improved were studied retrospectively. 19 patients(treatment group) were applied accent method and the other 19 patients(control group) refused voice therapy. The voice of all the patients of both group were analysed with CSL and Aerophone II programs in pre- and post operative period. The voice of treatment group were analysed with Visi-Pitch II program before the application of accent method and after the completion of accent method. Then, the results were compared using paired t-test. Results : The results of voice analysis were not different statistically between pre- and postoperative examination in both group. After application of accent method in the treatment group, fundamental frequency(F$_{0}$) of male, relative average pertubation, and shimmer were revealed significant differences(p＜0.01), and decrease in grade(G) scale and roughness(R) scale were statistically Important in perceptual analysis using GRBAS criteria(p＜0.01). But $F_0$ of female, maximal phonation time and S to Z ratio were not revealed significant differences. Conclusions : Accent method of voice therapy may be as a supplement- ary therapy in the patients who were not improved after surgery.