• Title/Summary/Keyword: Voice disorders

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Differential Diagnosis between Neurogenic and Functional Dysphonia (신경성 발성장애와 기능성 발성장애의 감별 진단)

  • Kim, So Yean;Lee, Sang Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.28 no.2
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    • pp.71-78
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    • 2017
  • Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

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The Utility of Perturbation, Non-linear dynamic, and Cepstrum measures of dysphonia according to Signal Typing (음성 신호 분류에 따른 장애 음성의 변동률 분석, 비선형 동적 분석, 캡스트럼 분석의 유용성)

  • Choi, Seong Hee;Choi, Chul-Hee
    • Phonetics and Speech Sciences
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    • v.6 no.3
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    • pp.63-72
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    • 2014
  • The current study assessed the utility of acoustic analyses the most commonly used in routine clinical voice assessment including perturbation, nonlinear dynamic analysis, and Spectral/Cepstrum analysis based on signal typing of dysphonic voices and investigated their applicability of clinical acoustic analysis methods. A total of 70 dysphonic voice samples were classified with signal typing using narrowband spectrogram. Traditional parameters of %jitter, %shimmer, and signal-to-noise ratio were calculated for the signals using TF32 and correlation dimension(D2) of nonlinear dynamic parameter and spectral/cepstral measures including mean CPP, CPP_sd, CPPf0, CPPf0_sd, L/H ratio, and L/H ratio_sd were also calculated with ADSV(Analysis of Dysphonia in Speech and VoiceTM). Auditory perceptual analysis was performed by two blinded speech-language pathologists with GRBAS. The results showed that nearly periodic Type 1 signals were all functional dysphonia and Type 4 signals were comprised of neurogenic and organic voice disorders. Only Type 1 voice signals were reliable for perturbation analysis in this study. Significant signal typing-related differences were found in all acoustic and auditory-perceptual measures. SNR, CPP, L/H ratio values for Type 4 were significantly lower than those of other voice signals and significant higher %jitter, %shimmer were observed in Type 4 voice signals(p<.001). Additionally, with increase of signal type, D2 values significantly increased and more complex and nonlinear patterns were represented. Nevertheless, voice signals with highly noise component associated with breathiness were not able to obtain D2. In particular, CPP, was highly sensitive with voice quality 'G', 'R', 'B' than any other acoustic measures. Thus, Spectral and cepstral analyses may be applied for more severe dysphonic voices such as Type 4 signals and CPP can be more accurate and predictive acoustic marker in measuring voice quality and severity in dysphonia.

Analysis of acoustical characteristic changes in voice after drinking and singing (음주 및 가창 후 음성의 음향학적 특성 변화 분석)

  • Hwang, Bo-Myung;Noh, Dong-Woo;Paik, Eun-A;Jeong, Ok-Ran
    • Speech Sciences
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    • v.8 no.2
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    • pp.39-48
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    • 2001
  • The purpose of this study was to examine changes in acoustic characteristics after drinking alcoholic beverages and singing in order to establish guidelines for vocal hygiene of both singers and non-singers. 21 university students (10 males and 11 females) vocalized /a/ before drinking, after drinking and after singing. Changes in vocal range and acoustic characteristics were analyzed by Dr. Speech 4.0 (Tigers Electronics). No significant difference was observed in vocal range following drinking. However, there was statistically significant changes in vocal range after singing. We may infer that appropriate amount of singing functioning as vocal warm-up, rather than drinking alone, resulted in improvement in their abilities to lengthen vocal folds. This is directly related to the ability to produce high-pitched sounds. Changes in jitter in female voices after singing was the only acoustic factor that was significant. Changes in Shimmer and NNE was not significant either after drinking nor singing. Subjects who were judged to perform better in singing were marked by minimum acoustic changes, which may due to their well-trained vocal fold function. The results of this study may address the necessity for vocal function exercises for the patients with neurogenic voice disorders including dysarthria. The need for more extensive research with a larger number of subjects including professional voice users is also addressed.

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Acoustic Characteristics of the Smoking Patients in the Voice Disorders (흡연환자 음성의 음향학적 특성에 관한 연구)

  • Lee, Myeong-Hee;Lee, Seung-Rho;Moon, Seung-Young;Lim, Sang-Ho;Cho, Young-Joo;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.2
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    • pp.123-127
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    • 2008
  • Background and Objectives: Smoking has been identified as one of the main determinants of negative changes on the larynx histology. The purpose of this study is to investigate the voice characteristics and correlation between voice parameters of the smokers with vocal polyp or nodule or both of them. Materials and Method: MPT, $F_0$, jitter, shimmer, NHR of Korean /a/ vowel from 54 smokers and 50 nonsmokers diagnosed as vocal polyp or nodule were analyzed. A Computerized Speech Lab (4400) was for the analysis of each voice sample and statistical analysis was done by one-way ANOVA and Pearson correlation coefficient. Result and Conclusion: It showed that we can find difference between smokers and nonsmokers group in MPT, $F_0$, jitter, shimmer were different except NHR. each group shows difference in correlation coefficient between MPT, $F_0$, jitter, shimmer.

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The Comparisons of GRBAS Perceptual Judgments according to Levels of Utterances

  • Pyo, Hwa-Young;Sim, Hyun-Sub
    • Speech Sciences
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    • v.8 no.1
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    • pp.135-142
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    • 2001
  • The present study was performed to investigate adequate levels of utterances which can give essential as well as useful information about the patients' voice, by examining the degrees of correlation between the levels of utterances (vowels, words, and phrase paragraph reading) and the entire utterance including all of the levels. For this purpose, a total of 10 individual utterance samples (5 vowels, 3 words, 1 phrase, 1 paragraph reading) were collected from each of the 30 subjects with voice disorder patients, and four experienced voice therapists evaluated them using GRBAS. The results showed that four therapists highly agreed upon on 'G' parameter. The coefficient of the correlation between each level of utterance and entire utterance tended to be above 0.70. Judgements of the vowel /$\varepsilon$/ as well as /o/ highly correlated with the judgement of the entire utterance. Regardless of severity, the judgement of the entire utterance highly correlated with the judgements of the vowel /u/ and the paragraph reading. These results suggest that experienced voice therapists can precisely evaluate patients' voice quality with only one sustained vowel in the clinic field, as is done with the entire utterance evaluation.

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A Study on the Validation of Phonation Threshold Power and the Clinical Usefulness of PTW: A Preliminary Study (발성역치능력(Phonation Threshold Power, PTW)의 타당도 및 임상적 유용성 연구: 예비연구)

  • Hwang, Youngjin;Lee, Inae
    • Phonetics and Speech Sciences
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    • v.6 no.2
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    • pp.133-138
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    • 2014
  • This study attempted to investigate the validation of Phonation Threshold Power of Patients who have Functional voice disorder. 50 subjects participated in the study (32 subjects were patients who had functional voice disorders and 20 subjects were normal adults). The PAS (Phonatory aerodynamic system, model 6600, KAY electronics, Inc.) was used to measure the data and to do the analysis. Data from the Phonation Threshold Power was measured multiplying Phonation Threshold Pressure and Phonation Threshold Airflow. Phonation Threshold Pressure and Phonation Threshold Airflow were measured by the PAS protocol. Those were used because of the ease of phonation. The results of this study showed that the differences in Phonation Threshold Power between patients who had functional voice disorder and normal adults could become a significant index. Patients who had functional voice disorder showed more higher figures than normal adults. The results of study showed that Phonation threshold Power is more sensitive than Phonation Threshold Pressure and Phonation Threshold Airflow. The measured data also provided useful information for diagnosing patients with vocal fold.

The Correlation between Speech Intelligibility and Acoustic Measurements in Children with Speech Sound Disorders (말소리장애 아동의 말명료도와 음향학적 측정치 간 상관관계)

  • Kang, Eunyeong
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.4
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    • pp.191-206
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    • 2018
  • Purpose : This study investigated the correlation between speech intelligibility and acoustic measurements of speech sounds produced by the children with speech sound disorders and children without any diagnosed speech sound disorder. Methods : A total of 60 children with and without speech sound disorders were the subjects of this study. Speech samples were obtained by having the subjects? speak meaningful words. Acoustic measurements were analyzed on a spectrogram using the Multi-speech 3700 program. Speech intelligibility was determined according to a listener's perceptual judgment. Results : Children with speech sound disorders had significantly lower speech intelligibility than those without speech sound disorders. The intensity of the vowel /u/, the duration of the vowel /${\omega}$/, and the second formant of the vowel /${\omega}$/ were significantly different between both groups. There was no difference in voice onset time between the groups. There was a correlation between acoustic measurements and speech intelligibility. Conclusion : The results of this study showed that the speech intelligibility of children with speech sound disorders was affected by intensity, word duration, and formant frequency. It is necessary to complement clinical setting results using acoustic measurements in addition to evaluation of speech intelligibility.

Development and validation of Speech Range Profile task (발화범위 프로파일 과제 개발 및 타당성 검증)

  • Kim, Jaeock;Lee, Seung Jin
    • Phonetics and Speech Sciences
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    • v.11 no.3
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    • pp.77-87
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    • 2019
  • The study aimed to develop Speech Range Profile (SRP) and to examine and validate its clinical application. Forty-five participants without voice disorders aged 18-29 years were compared using SRP and Voice Range Profile (VRP). The authors developed the "Fire!" paragraph as a SRP task compromising 14 sentences including all Korean spoken phonemes and sentence types. To compare SRP and VRP results, the participants read the paragraph (reading) and counted from 21 to 30 (counting) as a part of SRP tasks, and produced a vowel /a/ from low to high frequencies (gliding) and a shortened form of the VRP as a part of VRP tasks. $F0_{max}$, $F0_{min}$, $F0_{range}$, $I_{max}$, $I_{min}$, and $I_{range}$ for each task were measured and compared, showing that $F0_{max}$, $F0_{min}$, $F0_{range}$, $I_{max}$, and $I_{range}$ were not different between reading and gliding. $I_{min}$, had the lowest value in counting. It is concluded that the newly developed SRP task, reading the "Fire" paragraph, can yield a maximum phonation range similar to that found by VRP. Therefore, it is expected that voice evaluation can be effectively performed in a relatively short time by applying SRP with the "Fire" paragraph, a functional utterance task, in place of VRP, which may be difficult to measure long term or in cases of severe voice disorders.

Speech Production Characteristics of Congenitally Deaf Children with Cochlear Implant (선천성심도 청각장애 아동의 와우이식 후 말산출 특성)

  • Yoon, Mi-Sun
    • Proceedings of the KSPS conference
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    • 2007.05a
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    • pp.302-304
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    • 2007
  • The purpose of this study was to evaluate speech production ability of congenitally deaf children with cochlear implant. Forty children were participated in the study. The results are following: (1) mean of speech intelligibility score was 3.05 in 5 point scale, (2) mean of percent of correct vowels was 86.19%, and mean of percent of correct consonants was 74.89%, and (3) voice profiles showed their voice were high pitched, hypernasal, and breathy. But 12.5% of the children were evaluated as having normal voice quality. Overall speech production abilities of children with cochlear implant were superior than the deaf children's result reported in literatures. Meanwhile their abilities were not same as children with normal hearing.

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Design and Implementation of Speech-Training System for Voice Disorders (발성장애아동을 위한 발성훈련시스템 설계 및 구현)

  • 정은순;김봉완;양옥렬;이용주
    • Journal of Internet Computing and Services
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    • v.2 no.1
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    • pp.97-106
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    • 2001
  • In this paper, we design and implement complement based speech training system for voice disorder. The system consists of three level of training: precedent training, training for speech apprehension and training for speech enhancement. To analyze speech of voice disorder, we extracted speech features as loudness, amplitude, pitch using digital signal processing technique. Extracted features are converted to graphic interface for visual feedback of speech by the system.

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