• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.2
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• pp.89-96
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• 2022

Background and Objectives The quality of life after thyroidectomy, such as voice change, is considered to be as important as control of the disease. In this study, we aimed to evaluate changes in both subjective and objective voice parameters after thyroidectomy resulting in normal morbidity of the vocal cords. Materials and Method In this prospective cohort study, 204 patients who underwent thyroidectomy with or without central neck dissection at a single referral center from Feb 2015 to Aug 2016 were enrolled. All patients underwent prospective voice evaluations including both subjective and objective assessments preoperatively and then at 2 weeks, 3, 6, and 12 months postoperatively. Temporal changes of the voice parameters were analyzed. Results Values of the subjective assessment tool worsened during the early postoperative follow-up period and did not recover to the preoperative values at 12 months postoperatively. The maximal phonation time gradually decreased, whereas most objective parameters, including maximal vocal pitch (MVP), reached preoperative values at 3-6 months postoperatively. The initial decrease in MVP was significantly greater in patients undergoing total thyroidectomy, and their MVP recovery time was faster than that of patients undergoing lobectomy (p=0.001). Patients whose external branch of the superior laryngeal nerve was confirmed intact by electroidentification showed no difference in recovery speed compared with patients without electroindentification (p=0.102), although the initial decrease in MVP was lower with electroidentification. Conclusion Subjective assessment in voice quality and maximal phonation time after thyroidectomy did not show recovery to preoperative values. Aggravation of MVP was associated with surgical extent and electroidentification.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.104-111
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• 2015

Background and Objectives : Acoustic analysis of voice could be influenced so much by the quality of voice files which were recorded by recording device. In clinical practice, voice files that were recorded by analysis program directly or portable digital recording device were analyzed mostly. This study examined the feasibility of using Galaxy smartphone recordings for acoustic analysis of voice. Materials and Methods : Acoustic measures were compared between voice signals recorded from 30 normal speakers (15 males and 15 females) through Galaxy smartphone, portable digital recording device and CSL. Fo, jitter, shimmer, NHR (Noise-Harmony ratio) and Formant frequencies were analyzed by MDVP. Results : Fo, Jitter, Shimmer, NHR and formant frequencies from 3 devices were no significantly difference. The intraclass correlation coefficient (ICC) was higher between each of the voice perturbation measures. Conclusion : The findings indicated that Galaxy smartphone recording system was useful device for acoustic analysis of voice. Furthermore, Galaxy smartphone can be applied widely in various way for acoustic analysis of voice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.43-47
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• 2021

Voice therapy is effective in many voice and speech disorders. However, patients have low accessibility to therapeutic facilities due to disease-unrelated reasons such as lack of time and pandemic of COVID-19. Contactless voice therapy could be an alternative and may helpful to all patients with voice and speech problems. We developed contactless voice and speech therapy program on the necessity of improving accessibility. Herein, we report the first case of voice therapy to 30 year-old female patient who complained voice change after total thyroidectomy using contactless voice and speech therapy service platform in Korea.

• Proceedings of the KSLP Conference
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• 2017.04a
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• pp.109-109
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• 2017

• Phonetics and Speech Sciences
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• v.2 no.3
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• pp.165-170
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• 2010

In this study, the most stable portion was identified using 5% moving window during /a/ sustained phonation in normal and pathologic voice signals and the perturbation values were compared between normal and pathologic voices at the mid-point and at the most stable portion using moving window, respectively. The results revealed that some severe pathologic voice signals can be eligible for perturbation analysis by identifying the most stable portion with Err less than 10. In addition, the perturbation acoustic parameters did not differentiate the pathologic voice signals from the normal voice signals when the mid-point was selected to measure the perturbation analysis(p>0.05). However, significantly higher %shimmer and lower SNR values were observed in pathologic voices (p<0.05) when the most stable portion was selected by moving window. In conclusion, moving window could identify the most stable portion objectively which can allow toget the minimum perturbation values (%jitter, %shimmer) and maximum SNR values. Thus, moving window technique can be applicable for more reliable and accurate perturbation acoustic analysis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.2
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• pp.128-132
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• 2004

Objectives : The total laryngectomy for laryngeal cancer has made patients be afraid of voice loss. Early staged glottic or supraglottic cancer can be treated with conservative laryngeal surgery which preserve voice, though which was not normal voice comparing before. Voice analysis is used to evaluates objectively the quality of the voice in pre- and postoperation, 4 different types of conservative laryngeal surgery : laser cordectomy, supracticoid partial laryngectomy, vertical partial laryngectomy, and supralottic laryngectomy. Materials and Methods : The patients who received conservative laryngeal surgery(laser cordectomy : 23 cases, vertical partial laryngecotmy : 9cases, supracriocoid partial laryngectomy : 6cases, supraglottic laryngectomy : 8cases) from 1995 to 2001 in the Asan medical center. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum comfortable phonation time and subglottic pressure were used as parameters for voice analysis. Results : The patients who received laser cordectomy(shimmer : 5.26${\pm}$1.12%, jitter : 3.33${\pm}$0.42%, NHR : 0.47${\pm}$0.02, MPT : 9.32${\pm}$3.59sec) and supraglottic laryngectomy(shimmer : 4.39${\pm}$1.03%, jitter : 1.49${\pm}$0.14%, NHR : 0.51${\pm}$0.06, MPT : 8.9${\pm}$0.59sec) showed better results than other two procedures, but differed from normal value. Especially the patients who received supracricoid partial laryngectomy(shimmer : 9.23${\pm}$1.56%, jitter : 5.81${\pm}$1.23%, NHR : 5.89${\pm}$1.13, MPT : 6.3${\pm}$1.18sec, MFR : 632${\pm}$89ml/sec) had poorer quality of voice but presented fast functional recovery time, and the subjective symptom was improved as time goes by slowly. Conclusion : The appropriate conservative laryngeal surgery for each cancers and stage can preserve the acceptable voice for patients. Supracricoid partial laryngectomy for T1b glottic cancer can be used for acceptable voice despite its poor voice analysis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.3
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• pp.130-134
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• 2021

Background and Objectives Voice therapy (VT) is considered to be the gold standard of treatment of vocal fold nodule in children. This study was designed to analyze the success rate of pediatric VT and investigate the predictive factors for good response of periatic VT for vocal fold nodule. Materials and Method This was a retrospective cohort study of 23 patients under 18 years old who were diagnosed with vocal fold nodule and received pediatric VT. We divided the patients into responding and non-responding groups. We analyzed clinical and voice parameters related to the voice results. Results Twelve patients showed improved findings after VT. By univariate analysis, female patients (85.7%) and adolescence children (100%) showed a good response to VT. In multivariate analysis, female sex (p<0.05) and adolescence children (p<0.05) were significantly related to a successful voice response. Proton pump inhibitor or antihistamine, mucolytics treatment and pre-VT voice parameters did not significantly influence voice outcomes. Conclusion Pediatric VT is more effective in female and adolescence children.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.94-97
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• 2021

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO₂ laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

• Speech Sciences
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• v.14 no.4
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• pp.179-200
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• 2007

In voice pathology, various measurements calculated from pitch values are proposed to show voice quality. However, those measurements frequently seem to be inaccurate and unreliable because they are based on some wrong pitch values determined from pathological voice data. In order to solve the problem, we compared several pitch estimation methods to propose a better one in pathological voices. From the database of 99 pathological voice and 30 normal voice data, errors derived from pitch estimation were analyzed and compared between pathological and normal voice data or among the vowels produced by patients with benign vocal fold lesions. Results showed that gross pitch errors were observed in the cases of pathological voice data. From the types of pathological voices classified by the degree of aperiodicity in the speech signals, we found that pitch errors were closely related to the number of aperiodic segments. Also, the autocorrelation approach was found to be the most robust pitch estimation in the pathological voice data. It is desirable to conduct further research on the more severely pathological voice data in order to reduce pitch estimation errors.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.16-20
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• 2008

Excising part or all part of a larynx as a cancer operation results in changes that transgress anatomic, physiologic, psychologic, and social priciples. The quality of life of a patient's life after any given cancer surgery usually is regarded as a second-priority consideration after oncologic safety. With laryngeal surgery, excision of malignant disease typically results in change that significantly influence an individual for the duration of his or her life. Nonetheless, with appropriate rehabilitation the surgical side effects can be minimized to allow for an excellent quality of life. Successful conservation surgery for laryngeal cancer requires careful interdependent selection for patients, lesions and procedure. The technical goal is to minimize trauma to uninvolved tissue and to wisely utilized local tissues or tree flap for reconstruction, while insuring for oncologically sound procedure. Rehabilitation should aim to produce a glottal sound source if possible, however voice therapy to promote false vocal fold vibration and arytenoid to epiglottis source of vibration can produce very satisfactory phonatory results.