• 제목/요약/키워드: Voice disorder

검색결과 128건 처리시간 0.024초

갑상선암 수술과 수술 전후 음성관리 (Perioperative Management of the Voice in Thyroid Cancer)

  • 윤소연;홍현준
    • 대한후두음성언어의학회지
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    • 제31권2호
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    • pp.49-55
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    • 2020
  • Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

틱장애를 주소(主訴)로 하는 환아(患兒)의 증례(症例) 보고(報告) (A Case of Tic Disorder)

  • 이승희;장규태;김장현
    • 대한한방소아과학회지
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    • 제15권2호
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    • pp.111-119
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    • 2001
  • Tic disorder which is purposeless, repeated, unexpected, involuntary behavior and voice can be divided into motor, vocal tic. Tic disorder belongs to pediatic psychosomatic disease. In four clinical cases, patients between the age of 6 to 15 consisted of three males and one females. They all are the eldest or only son and have the parental behavioral, home background and studing problem. The patients appealed to eye blinking in tic early stage and belong to chronic motor or vocal tic disorder or transient tic disorder without tourette's disorder. When estimated by an appraisal standard of Yale Global Tic Severity Scale(YGTSS). Four patients administered Bosimgeunatang known to invigorating the heart, relieving mental stress improved.

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발성장애 평가 시 /a/ 모음연장발성 및 문장검사의 켑스트럼 분석 비교 (Comparison of Vowel and Text-Based Cepstral Analysis in Dysphonia Evaluation)

  • 김태환;최정임;이상혁;진성민
    • 대한후두음성언어의학회지
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    • 제26권2호
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    • pp.117-121
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    • 2015
  • Background : Cepstral analysis which is obtained from Fourier transformation of spectrum has been known to be effective indicator to analyze the voice disorder. To evaluate the voice disorder, phonation of sustained vowel /a/ sound or continuous speech have been used but the former was limited to capture hoarseness properly. This study is aimed to compare the effectiveness in analysis of cepstrum between the sustained vowel /a/ sound and continuous speech. Methods : From March 2012 to December 2014, total 72 patients was enrolled in this study, including 24 unilateral vocal cord palsy, vocal nodule and vocal polyp patients, respectively. The entire patient evaluated their voice quality by VHI (Voice Handicap Index) before and after treatment. Phonation of sustained vowel /a/ sample and continuous speech using the first sentence of autumn paragraph was subjected by cepstral analysis and compare the pre-treatment group and post-treatment group. Results : The measured values of pre and post treatment in CPP-a (cepstral peak prominence in /a/ vowel sound) was 13.80, 13.91 in vocal cord palsy, 16.62, 17.99 in vocal cord nodule, 14.19, 18.50 in vocal cord polyp respectively. Values of CPP-s (cepstral peak prominence in text-based speech) in pre and post treatment was 11.11, 12.09 in vocal cord palsy, 12.11, 14.09 in vocal cord nodule, 12.63, 14.17 in vocal cord polyp. All 72 patients showed subjective improvement in VHI after treatment. CPP-a showed statistical improvement only in vocal polyp group, but CPP-s showed statistical improvement in all three groups (p<0.05). Conclusion : In analysis of cepstrum, text-based analysis is more representative in voice disorder than vowel sound speech. So when the acoustic analysis of voice by cepstrum, both phonation of sustained vowel /a/ sound and text based speech should be performed to obtain more accurate result.

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목사들의 음성발성에 대한 음향분석학적 특징 (Acoustic and Stroboscopic Characteristics in Clergies)

  • 진성민;박상욱;강현국;이경철;이용배;김보형
    • 대한후두음성언어의학회지
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    • 제9권1호
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    • pp.47-52
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    • 1998
  • Objectives : To compare the objective differences in voice quality and voice problems between clergies and normal male control group. Materials and Methods : The sustained vowel sound of 46 clergies and 40 normal persons were analyzed, using a videostroboscopy and acoustic analyzer. Together with these analyses, a questionnaire associated with current and past voice problems was handed over to the patients. Results : The most common symptom in subjective group was the voice fatigue. Stroboscopic findings in subjective group were as following 23 cases(50%) of pachydermia, 17 cases(37%) of phase difference, 12 cases(25%) of anterior-posterior contracture, 6 cases(13%) of vocal polyp and 3 cases(7%) of vocal nodule. The mean maximal phonation time in clergies was 17.8 seconds and in control group was 19 seconds. litter, pitch perturbation quotient and shimmer were significantly increased in subjective group than in control group(p<0.05), but there were no significant differences between two groups in fundamental frequency, vFo, amplitude perturbation quotient and noise to harmonic ratio. Conclusion : In the clergies using loud and forceful voice, vocal polyp and functional voice disorder findings were frequently noted in stroboscopic examination. litter and shimmer, reflecting the roughness of voice, were increased in acoustic analysis. Therefore, clergies, classified into untrained professional voice users, need professional career guidance and counseling.

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후두미세수술후 지속적인 음성장애환자에 대한 임상적 고찰 (Clinical Analysis of Persistent and Recurrent Postoperative Dysphonia)

  • 김명상;표화영;최홍식;김영호;김광문
    • 대한후두음성언어의학회지
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    • 제8권2호
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    • pp.225-231
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    • 1997
  • The persistent and recurrent dysphonia after microlaryngeal surgery was noted in tweleve patients. We reviewed the results of laryngostroboscopy, psychoacoustic evaluation, aerodynamic study and acoustic analysis according to the treatment modality. The causes of persistent dysphonia were attributed to vocal cord scarring, recurrent mass lesion, residual mass lesion, persistent inflammation, and hyperfunctional voice disorder. We noticed the better vocal function in the group treated with voice therapy or surgical therapy than the group treated with voice rest and medication. Therefore, we concluded that vocal function can be improved with the use of active, multidisciplinary approach which includes voice therapy, medical treatment and selected surgical resection according to the laryngeal lesions.

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젊은 성인 및 노인 음성장애 환자의 연속발화시 공기역학적 특성 비교 (Aerodynamic Characteristics of Young and Elderly Adult Patients with Voice Disorders during Continuous Speech)

  • 표화영
    • 한국콘텐츠학회논문지
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    • 제19권12호
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    • pp.270-278
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    • 2019
  • 본 연구는 젊은 성인 음성장애 환자 집단과 노인 음성장애 환자 집단을 대상으로 문단낭독시 공기역학적 특성을 비교해보고자 시행되었다. 20-45세의 남성 음성장애 환자 12명과 60세 이상의 남성 음성장애 환자 9명이 연구에 참여하였다. PAS(Phonatory Aerodynamic System)의 Running Speech를 이용하여 문단을 낭독하게 하고 공기역학 측정치를 구하였다. 그 결과 노인집단은 젊은 성인집단보다 더 긴 지속시간과 더 적은 기류량 및 기류체적을 보였다. 그러나 그 차이는 발성지속시간에서만 유의하게 나타났다. 공기역학 측정치는 일반적으로 노인보다 젊은 성인이 모든 측면에서 비정상 소견을 보일 것이라고 예상하지만 본 연구결과 노인집단이 보인 측정치는 발성지속시간을 제외하고 기류량과 기류체적은 젊은 성인집단과 비슷한 수치를 보인것으로 나타났다. 그러므로 노인 음성장애 환자의 연속발화시 공기역학 측정치가 갖는 의미를 해석할 때 기류와 기류체적은 연령뿐 아니라 발화자료, 폐 기능 등 다양한 요건을 함께 고려해야 한다.

성악도들의 음성관리 및 성대화상술상의 문제점과 발성에 대한 음향분석학적 특징 (Problems of Strobovideolarygoscopic Findings and Usual Voice Management of Vocal Major Students, and Acoustic Characteristics of Singing Voice)

  • 진성민;김대영;반재호;이상혁;송윤경;권기환;이경철;이용배
    • 대한후두음성언어의학회지
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    • 제10권1호
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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.

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궁형 성대를 보이는 환자들에 있어 음성치료의 효과 (The Efficacy of Voice Therapy for the Treatment of Vocal Fold Bowing)

  • 신혜정;김진경;김은아;고영민;박애경;정성민
    • 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.

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전신질환과 관련된 음성장애의 치료 (The Management of Systemic Voice Disorders)

  • 우주현
    • 대한후두음성언어의학회지
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    • 제27권1호
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    • pp.5-10
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    • 2016
  • Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

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각종 후두질환에서 음성치료의 효과 (The Efficiency of Voice Therapy on Various Laryngeal Disorders)

  • 왕수건;권순복;노환중;고의경;전경명
    • 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.

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