• 대한후두음성언어의학회지
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• 제30권1호
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• pp.9-11
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• 2019

Botulinum toxin (BTX) has been widely used to treat muscle spasms in many voice disorders. Most commercially available forms of BTX require reconstitution before use, which may increase the risk of contamination and requires careful titration. Recently, a liquid-type BTX type A (BTX-A) has been developed, which should simplify the procedure and enhance its efficacy. In this session, I will discuss about the differences of BTX-A from existing types and the practical issues associated with it.

• 말소리와 음성과학
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• 제14권2호
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• pp.77-86
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• 2022

본 연구는 조기 양측 인공와우이식 아동과 건청 아동 간 파열음의 조음위치와 발성유형에 대한 성대진동 시작시간(voice onset time, VOT)의 차이를 살펴봄으로써, 조기 양측 인공와우이식을 통한 청각적 보상과 피드백이 청각장애 아동의 말 운동통제 능력에 미치는 영향을 살펴보고자 하였다. 대상자는 만 5세부터 10세 사이의 양측 인공와우이식 아동 15명과 건청 아동 15명을 선정하였다. 검사 과제는 조음위치 및 발성 유형을 고려한 9개 파열음의 VCV음절을 사용하였다. VOT 측정을 위해 Praat 프로그램을 사용하였으며, 정확한 측정을 위해 녹음된 음성, 스펙트로그램, 포먼트 정보를 함께 사용하였다. 삼원혼합분산분석 결과, 집단에 대한 주 효과는 유의하지 않았다. 조음위치에 대한 주 효과는 유의하였으며, 연구개음의 VOT값이 양순음과 치조음보다 유의하게 길었다. 발성유형에 대한 주 효과도 유의하였으며, VOT값은 격음, 평음, 경음 순으로 유의하게 길었다. 이러한 결과는 조기 양측 인공와우이식을 통한 양이 청취가 고도 이상의 난청 아동의 말 운동 통제 능력에 긍정적인 영향을 준다는 것을 시사한다.

• 대한후두음성언어의학회지
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• 제27권2호
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• pp.108-113
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• 2016

Background and Objectives : After thyroidectomy, many patients experience problems report such things as reduced voice range and vocal fatigue, swallowing problems without superior and recurrent laryngeal nerve injury. The purpose of this study was to evaluate voice and swallowing problems before and after thyroid surgery without laryngeal nerve injury. Materials and Methods : Ninety-three patients who underwent thyroidectomy without laryngeal nerve injury and completed the follow-up evaluations were studied between June 2013 and December 2015. Each evaluation was performed preoperatively, as well as 1 week, 1 month postoperatively. Analysis was performed including voice handicap index (VHI), dysphagia handicap index (DHI), and acoustic voice analysis. Results : Patients show significant variation of parameters in the fundamental frequency (F), maximal phonation time (MPT), shimmer, jitter and soft phonation index (SPI) early after operation, and most of them showed recovery of parameters after 1month of operation. Perceptive complaint of voice and swallowing also showed significant decreased after operation (p<0.005). After 1month of operation, MPT, highest frequency and frequency ranges still showed significant decreased parameters. Comparing acoustic and perceptive parameters of total thyroidectomy and lobectomy, there was no significant changes between them except highest frequency (p=0.042). Conclusion : The results from both subjective and objective evaluations show voice and swallowing disturbance after thyroidectomy even in the absence of laryngeal nerve and provide patients information about the recovery process after surgery. Highest frequency parameter showed most significant changes after operation.

• 음성과학
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• 제15권3호
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• pp.95-102
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• 2008

Multiple physical changes of the larynx and its components occur with age. Vocal pitch, commonly expressed through measures of fundamental frequency (Fo) relate to physical conditions of the larynx. Available data is lacking for the senescent voice, and should be applied to the of changes of elderly speakers' Fo characteristics. The purpose of this study was to investigate the Fo of normal elderly speaker's voice. A total of 406 normal elderly speakers (207 males and 199 females) participated in this experiment. Age ranged from 60 years to 89 years. The subjects were asked to produce sustained corner vowels (/a/ /i/ /u/) three times each and the data were analyzed using the MDVP of CSL. According to the results of this study, the mean Fo from the ages of 60's to 80's shows 143.95Hz(SD 13.94) for men and 185.42Hz (SD 15.29) for women. For men, a significant change is found as a function of age in the Fo (F=16.181, p<.05). A post-hoc Scheffe test revealed significant differences between the Fo data of subjects aged 60's and 70's, 60's and 80's. For women, a significant change is found as a function of age in the Fo (F=49.013, p<.05). A post-hoc $Scheff'{e}$ test revealed significant differences between the Fo data of subjects in their 60's and 70's, 70's and 80's, 60's and 80's. The Fo of men goes up from their 60's to 80's gradually, whereas the Fo of women goes down gradually until their 70's, and after their 70's it again increases. It has been known that diminishing estrogen levels in women in old age may be a factor in lowering Fo, whereas diminishing testosterone levels in men may contribute to a rising Fo. This result may be used as some meaningful guideline and lead the basic data to differentiate between normal aged voice and aged voice disorders.

• 음성과학
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• 제8권2호
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• pp.23-37
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• 2001

The primary sound produced by the vibration of vocal folds reaches the velopharyngeal isthmus and is directed both nasally and orally. The proportions of the each component is determined by the anatomical and functional status of the soft palate. The oral sounds composed of oral vowels and consonants according to the status of vocal tract, tongue, palate and lips. The nasal sounds composed of nasal consonants and nasal vowels, and further modified according to the status of the nasal airway, so anatomical abnormalities in the nasal cavity will influence nasal sound. The measurement of nasal sounds of speech has relied on the subjective scoring by listeners. The nasal sounds are described with nasality and nasalization. Generally, nasality has been assessed perceptually in the effect of maxillofacial procedures for cleft palate, sleep apnea, snoring and nasal disorders. The nasalization is considered as an acoustic phenomenon. Snoring and sleep apnea is a typical disorders due to abundant velopharynx. The sleep apnea has been known as a cessation of breathing for at least 10 seconds during sleep. Several medical and surgical methods for treating sleep apnea have been attempted. The uvulopalatopharyngoplasty(UPPP) involves removal of 1.0 to 3.0 cm of soft palate tissue with removal of redundant oropharyngeal mucosa and lateral tissue from the anterior and sometimes posterior faucial pillars. This procedure results in a shortened soft palate and a possible risk following this surgery may be velopharyngeal malfunctioning due to the shortened palate. Few researchers have systematically studied the effects of this surgery as it relates to speech production. Some changes in the voice quality such as resonance (nasality), articulation, and phonation have been reported. In view of the conflicting reports discussed, there remains some uncertainty about the speech status in patients following the snoring and sleep apnea surgery. The study was conducted in two phases: 1) acoustic analysis of oral and nasal sounds, and 2) evaluation of nasality.

• 대한후두음성언어의학회지
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• 제26권2호
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• pp.112-116
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• 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.

• International Journal of Computer Science & Network Security
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• 제22권11호
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• pp.157-162
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• 2022

Cerebral palsy is one of the most serious forms of disorders of the psychophysical development of children, which manifests itself in disturbances of motor functions, which are often combined with speech disorders, other complications of the formation of higher mental functions, and often with a decrease in intelligence. The article will discuss the speech disorder in children with cerebral palsy. Emphasis is placed on some important aspects, which should bear in mind, investigating the problem of specifics of speech development of children with cerebral palsy. In particular at the heart of speech disorders in the cerebral palsy is not only damage to certain structures of the brain, but also the later formation or underdevelopment of those parts of the cerebral cortex, which are of major importance in linguistic and mental activity. This is an ontogenetically young region of the cerebral cortex, which is most rapidly developing after birth (premotor, frontal, temmono-temporal). It is important to take into account, that children with cerebral palsy have disturbances of phonemic perception. Often, children do not distinguish between hearing sounds, cannot repeat component rows, allocate sounds in words. At dysarthria, there are violations of pronunciation of vowel and consonant sounds, tempo of speech, modulation of voice, breathing, phonation, as well as asynchronous breathing, alignment and articulation. As a result, we identified the main features and specifics of the speech development of children with cerebral palsy and described the conditions necessary for the full development of language. Language disturbances in children's cerebral palsy depend on the localization and severity of brain damage. Great importance in the mechanism of speech disorders has a pathology that limits the ability of movement and knowledge of the world.

• 음성과학
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• 제10권2호
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• pp.99-109
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• 2003

The purpose of this study was to analyze and compare head register with chest register of singers acoustically. Fifteen healthy tenor major students were participated. Fifteen healthy untrained adults were chosen as the control group for this study. Long term average (LTA) power spectrum using the Fast Fourier transform (FFT) algorithm and Linear predictive coding (LPC) filter response were made with /a/ sustained in both head (G4, 392 Hz) and chest registers (C3, 131 Hz). Statistical analysis was performed using the Mann-Whitney test. In the LTA power spectrum, head register of singers increased in the level of energy gain within the frequency of 2.2-3.4 kHz (p<0.01), and 7.5-8.4 kHz (p<0.01, p<0.05). Chest register of singers increased in the frequency of 2.2-3.1 kHz (p<0.01), 7.8-8.4 kHz (p<0.05) and around 9.6 kHz (p<0.01). The LTA power spectrum revealed a peak of acoustic energy around 2,500 Hz, known as the singer's formant and another peak of acoustic energy around 8,000 Hz in the singer's voice.

• 대한후두음성언어의학회지
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• 제10권1호
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• pp.12-16
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• 1999

Background and Objectives : The common cause of voice disorders may be bad habits of phonation. faulty vocal habits might aggravate the voice disorder or make the dysphonia. Authors thought the analysis of faulty vocal habits might help to evaluate the causes and to choose the treatment methods in patients with dysphonia. Authors studied to evaluate which vocal habits were used in patients with dysphonia. Materials and Methods : Patients with dysphonia(N= 32) and person without dysphonia(N=20) were evaluated through pre-evaluation test by otolaryngologist and SLP. All subjects were evaluated accordingly Posture of body, expansion of cervical vein, excessive movements of thyroide prominence, position of tongue, tension of lower lip, tension of jaw, breathing pattern related with phonation. Results : In dysphonia group, we found 23 cases with tension of jaw, 15 cases with expansion of cervical vein, 7 cases with bad position of tongue, 3 cases with excessive movement of thyroid prominence and a lot of cases with bad breathing Pattern on Phonation. In control group, only 3 cases with bad position of tongue, 2 cases with tension of lower lip, 1 case with tension of jaw were found. Conclusions : More faulty vocal habits were found in dysphonia group. Authors thought faulty vocal habits could be the cause of dysphonia and aggravate the dysphonia and the control of vocal habits would be very important in patients with dysphonia.

• 대한후두음성언어의학회지
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• 제9권1호
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• pp.17-21
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• 1998

Benign vocal fold lesions such as polyps, nodules and edema are known to be caused by vocal trauma such as voice misuse and/or abuse. Even though these lesions are known to be caused by the same etiology, phonotrauma, they show widely different clinical features and different responses to voice therapy. Previous studies suggested that benign vocal fold lesions represent disturbance in the balance of the extracellular matrix(ECM) constituents of the vocal folds. Collagen is one of the major constituents of ECM. Among collagens, fibrillar collagens are most important ones for maintaining the structural integrity. On the basis of gross morphology, vocal polyps wert divided into angiomatous one and edematous one, and nodules were divided into conical one and sessile one. In these four groups, the pattern of distribution of various fibrillar collagens(type 1, 2, 3, 5) was studied by immunohistochemical staining using paraffin embedded tissues. Within each group, differences among collagen subtypes were insignificant. In edematous polyp, collagens were sparsely dispersed in lamina propria by diffuse edema. In angiomatous polyp, collagens were displaced into submucosal layer by hemorrhagic space. In nodules, collagens were stained compactly in lamina propria. Quite different distributions of fibrillar collagens between polyps and nodules are thought to suggest that vocal polyps and nodules are totally different disorders in their pathophysiology.