• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.686-691
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• 2018

Background and Objectives Previous studies have suggested the usefulness and importance of postoperative voice therapy, for which there are indirect and direct methods. The aim of this study was to evaluate the efficacy of treatment according to different voice therapy methods. Subjects and Method Patients with vocal polyp were divided into three groups. Group 1 received direct voice therapy after phonomicrosurgery and Group 2 indirect voice therapy after phonomicrosurgery. Group 3 did not receive any voice therapy. Results Perceptual, acoustic, aerodynamic voice outcome parameters differed significantly between pre and post-operative treatments. In almost all of the voice analysis, Group 1, who underwent direct voice therapy, improved more significantly compared with Group 2 and 3. Conclusion Postoperative voice therapy following phonomicrosurgery may be an effective adjuvant treatment in patients with vocal polyps. In particular, direct voice therapy can be effective for improving postoperative voice outcome.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.1
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• pp.45-49
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• 2022

Post-thyroidectomy syndrome refers to various voice changes experienced after the thyroid surgery. Among them, surgery or injection therapy has been prioritized over voice therapy for the bilateral vocal cord paralysis. However, if it is possible to determine whether voice therapy can be applied first, a faster treatment recovery will be possible. In this study, voice therapy was performed on a 59-year-old female patient with bilateral vocal cord paralysis after total thyroidectomy. This study is to presents the criteria for applying the voice therapy first for bilateral vocal folds paralysis and to share successful voice therapy sessions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.2
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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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.52-56
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• 2009

Background and Objectives : Vocal nodule is common inflammatory vocal cord lesion which could be improved by voice rest or voice therapy. But some patients, who do not have any improvement after voice therapy, should take laryngomicorsurgery or additional long-term voice therapy. So we try to find prognostic factors which affect the results of voice therapy. Materials and Methods: There are 36 patients (response group) whose symptoms improved after initial voice therapy and 16 patients (no response group) whose symptoms did not improve at all. We compared clinical features (durations of symptoms, voice abuse, laryngopharyngeal reflux), GRBAS scale, acoustic analysis, aerodynamic analysis and voice handicap index between the two groups from January, 2006 to June, 2008. Results: Response group underwent voice therapy 4.5 times (ave.) and no response group underwent 6.7 times (ave.). No response group has longer duration of symptoms, higher GRBAS scale score, higher NIH ratio, and higher MFR than those of response group. Conclusion : This study found that the prognosis of voice therapy in patients who have longer duration of symptoms, high NIH ratio, and bad perceptional test result is not likely to be good. In those cases, we should recommend earlier surgery, voice therapy after surgery, and inform about the necessity of long-term voice rehabilitation or voice therapy in order to get favorable compliance.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.17-22
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• 2017

Background and Objectives: Voice change after thyroidectomy may develop without injury of recurrent laryngeal nerve. Psychogenic or emotional factors related to voice change after thyroidectomy has been rarely studied. In this study, we sought to analyze the impact of anxiety on early state of post-thyroidectomy voice change. Materials and Methods: We made a retrospective chart review of 36 patients who underwent thyroidectomy for papillary thyroid carcinoma and voice exam before surgery, 2 weeks after and 1 month after surgery. All patients included in the study answered a questionnaire for State-Trait Anxiety Inventory ; STAI-KYZ (form Korean YZ). Clinico-pathologic factors and parameters of voice analysis were reviewed to analyze correlation to the anxiety index. Results: No differences were identified between clinicopathologic factors and preoperative parameters of voice analysis between patients with higher and lower level of anxiety. Noise to harmonic ratio (NHR) was higher in those patients with higher level of anxiety, 2 weeks after surgery (p=0.043). However, none of the parameters showed any difference 1 month later. Conclusion: With limited number of patients and short period of follow up, significant impact of preoperative anxiety on postoperative voice change after thyroidectomy could not be identified in this preliminary study.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.1
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• pp.18-22
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• 2013

The population of professional voice users is increasing in Korea, nowadays. Voice problems in professional voice users cause more negative impact to have their ability to work and maintain their well-being life. In this article, the authors reviewed the characteristics of professional voice users and described the evaluation methods, treatment option and managements in professional voice users.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.14-17
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• 2016

Hoarseness is a postoperative complication of thyroidectomy, mostly due to damage to the recurrent laryngeal nerve (RLN). Hoarseness may also be brought about via vocal cord dysfunction (VCD) due to injury of the vocal cords from manipulations during anesthesia, as well as from psychogenic disorders and respiratory and upper-GI related infections. The clinician or surgeon should 1) document assessment of the patient's voice once a decision has been made to proceed with thyroid surgery ; 2) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility 3) examine vocal fold mobility, or refer the patient to a clinician who can examine vocal fold mobility, once a decision has been made to proceed with thyroid surgery 4) educate the patient about the potential impact of thyroid surgery on voice once a decision has been made to proceed with thyroid surgery ; 5) inform the anesthesiologist of the results of abnormal preoperative laryngeal assessment in patients who have had laryngoscopy prior to thyroid surgery ; 6) take steps to preserve the external branch of the surperior laryngeal nerve(s) when performing thyroid surgery ; 7) document whether there has been a change in voice between 2 weeks and 2 months following thyroid surgery ; 8) examine vocal fold mobility or refer the patient for examination of vocal fold mobility in patients with a change in voice following thyroid surgery ; 9) refer a patient to an otolaryngologist when abnormal vocal fold mobility is identified after thyroid surgery ; 10) counsel patients with voice change or abnormal vocal fold mobility after thyroid surgery on options for voice rehabilitation.

• Phonetics and Speech Sciences
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• v.7 no.4
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• pp.77-83
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• 2015

Voice complication without the laryngeal nerve injury can occur after thyroidectomy. The purpose of this study is to investigate voice changes according to extent of thyroidectomy with acoustic analysis. Thirty-five female patients with papillary thyroid carcinoma took voice evaluation at before and 1 month, and 3 months after thyroidectomy. Acoustic analysis parameters were speaking fundamental frequency(SFF), min $F_0$, max $F_0$, dynamic range $F_0$, jitter, shimmer, noise-to-harmonic ratio(NHR), and Cepstral prominence peak(CPP). Repeated-measured analysis of variance was applied. Time-related voice changes showed significant differences in all parameters except NHR. At 1 month after surgery, voice quality was worse and pitch was decreasing, but voice quality and pitch were improving at 3-month follow-up. Voice changes according to the extent of surgery were in SFF, max $F_0$, and dynamic range $F_0$. Time by surgery-related voice change existed only in min $F_0$. The result showed that the severity of voice complication depended on the extend of thyroidectomy which had a negative impact on $F_0$-related parameters. The deterioration of voice quality at 1 month after thyroidectomy may be affected by the loss of thyroid hormone in the blood. The descent of $F_0$-related parameters may be impacted by laryngeal fixation of surgical site adhesion.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.2
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• pp.142-145
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• 2008

Background and Object: The aim of this study is to evaluate the change of patient's subjective voice handicap index (VHI) and acoustic parameters before and after laryngeal microsurgery for benign vocal cord disease. Materials and Method: We analyzed 78 patients who received laryngeal microsurgery for benign vocal cord disease from January 2004 to February 2007 retrospectively. There were 28 vocal polyp, 40 vocal nodule, 5 intracordal cyst and 5 Reinke's edema. Jitter, shimmer, harmony to noise ratio (HNR) were analyzed before surgery and 2-3months after surgery using the Doctor's speech science program. The voice handicap index introduced by the Pittsburgh Voice Center was used to examine patient's subjective change of voice quality. Results: Acoustic parameters of jitter, shimmer and HNR were improved in patients with vocal polyp and vocal nodule after surgery. The acoustic parameters were not improved in patients with Reinke's edema, statistically. Only jitter was improved significantly in patients with intracordal cyst (p<0.05). The VHI was significantly improved after surgery. The change of jitter and shimmer was significantly correlated with the change of VHI after surgery. Conclusion: The acoustic parameters and VHI were significantly improved in patients with benign vocal disease after laryngeal microsurgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.75-80
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• 2021

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly. Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared. Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved. Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient's vocalization and improving voice quality, pitch and loudness.