• 한국산학기술학회논문지
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• 제13권3호
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• pp.1161-1169
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• 2012

본 연구의 목적은 DSI의 성별에 다른 유용성을 살펴보고자 하였다. 본 연구는 GRBAS에서 모두 0점을 받은 경기도 및 서울에 거주하는정상 한국인 30명(남자 15명, 여자 15명)을 대상으로 2011년 3월부터 6월까지 실험하였다. DSI를 구성하고 있는 파라미터인 최대 발성시간, 최대 기본주파수, 최저 강도, Jitter(%)는 CSL 4500(Kay Pentax. USA)을 이용하여 측정하였다. 검사자는 모든 피험자에게 실험조건과 절차에 대해서 설명해 주었으며, 본 실험에 앞서 시범을 보여주었다. 성(性)이 DSI에 미치는 영향을 살펴보기 위해서 Mann-Whitney 검정을 실시하였다. 본 실험 결과, 여성이 남성에 비해 최대 기본주파수는 높았지만 남녀간 DSI는 통계적으로 유의한 차이가 없었다. 따라서 DSI는 음성장애의 심한정도를 살펴볼 수 있는 객관적인 측정도구로 유용하다고 생각한다.

• 말소리와 음성과학
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• 제6권3호
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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.

• 말소리와 음성과학
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• 제10권4호
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• pp.91-99
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• 2018

Korean stops are currently undergoing a tonogenetic sound change, as found in the Seoul dialect in which a merged VOT of aspirated and lax stops induces F0 to be the primary cue for distinguishing the two stops and the lax stops have lower F0 than the aspirated stops. In tonal languages, low tone is produced with a breathy voice. This study investigated whether there are changes in voice quality with respect to the tonogenetic sound change of Korean stops. Two age groups speaking the Seoul dialect participated in this study: five females and six males born in the 1940s and 1950s and nine females and eight males born in the 1980s and 1990s. This study replicated previous findings of VOT and F0 and further examined H1-H2, H1-A1, and H1-A2 to see how they correlate with the sound change. In the older and younger generations, H1-H2, H1-A1, and H1-A2 were significantly lower after the tense stops than after the aspirated and lax stops, but they were not significantly different after the aspirated and lax stops. However, the younger females exhibited some different results for H1-H2 and H1-A2 than the older generation. In the younger females, the H1-H2 mean was higher after the aspirated stops than it was after the lax stops at the vowel onset, and the H1-H2 difference increased at the vowel midpoint. Although there was an inter-speaker variation in the results of H1-H2 and H1-A1, analyses of individual speakers showed that the H1-H2 and H1-A1 were higher after the lax stops than after the aspirated stops in the younger female speakers. These results indicate that lax stops tend to be breathier than aspirated stops in the younger female speakers. They also indicate that changes in voice quality are on Korean stops with tonal sound change, but are still developing.

• 말소리와 음성과학
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• 제13권4호
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• pp.67-74
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• 2021

본 연구는 영유아 교육시설에서 근무하는 음성의 불편감을 호소하는 10명의 여성 교사들을 대상으로 반폐쇄성도훈련(semi-occluded vocal tract exercise, SOVTE)을 원격으로 실시하였을 때 주관적으로 평가하는 음성평가에 미치는 효과를 살펴보았다. 원격 SOVTE의 효과는 한국어판 음성장애지수(Korean voice handicap index, KVHI), 음성 활동 및 참여 프로파일-한국판(Korean version of the voice activity and participation profile, K-VAPP), 음성노력도 및 GRBAS를 이용한 청지각적 평가로 평가하였다. 연구 결과, KVHI의 총 점수, 기능적 점수, 신체적 점수는 원격 SOVTE를 실시한 후에 통계적으로 유의하게 낮아졌다. 원격 SOVTE 실시 후 K-VAPP의 총 점수도 유의하게 감소하였으며, 음성노력도 또한 유의하게 감소하였다. 그러나 GRB 척도는 원격 SOVTE 실시 전과 후 간에 통계적으로 유의한 차이를 보이지 않았다. 본 연구를 통해 영유아 여성 교사에게 원격으로 실시한 SOVTE는 음성의 불편감을 감소시키는데 효과적임을 입증하였으며, 원격으로 실시한 음성치료가 효과가 있음을 보여준다.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.31-36
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• 2022

Background and Objectives Proton pump inhibitors (PPIs), mucolytics, and steroids were commonly recommended after phonomicrosurgery to prevent worsening of vocal fold (VF) scar formation and subglottal swelling. However, there is no consensus about whether laryngeal reflux and thick discharge are associated with the voice outcomes following phonomicrosurgery in benign VF lesions. The purpose of this study is to examine voice outcomes of use of PPIs, mucolytics,and steroids after phonomicrosurgery. Materials and Method This randomized controlled study is performed with patients undergoing laryngomicroscopic surgery for VF polyp and cyst. Participants were randomly assigned to 1) no medication, 2) PPIs, 3) PPIs+mucolytics, and 4) PPIs+mucolytics+steroids for 2 months postoperatively. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed pre- and post-operatively at 2 months. Parameters were compared among four groups. Results Among 85 patients, a total of 50 patients were included. The VHI-10, perceptual and acoustic parameters improved in all groups after surgery. However, there was no significant difference in those parameters among all groups. Conclusion PPIs, mucolytics, and steroids did not significantly influence voice outcomes after phonomicrosurgery in patients with benign VF lesions.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.16-20
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• 2004

Purpose : To assess perceptual, acoustic and aerodynamic measure of voice quality in patients with unilateral vocal cord paralysis before and after type I thyroplasty. Methods : The clinical records of patients operated type I thyroplasty in the Departement of otorhinoalryngolgy, Yongdong Severance hospital from November 2001 to November 2003 were reviewed. All patients uderwent a vocal function evaluation including perceptual, acoustic and aerodynamic measures of voice preoperative and on $60^{th}$ postoperative day. The perceptual and acoustic measures were obtained from recording of patients' reading a 'Sanchak' passage. The perceptual evaluation was performed by 2 speech pathologist using a 4-point rating scale. Acoustic parameters(voice range profile low(RAL), voice range profile high(RAH), average fundamental frequency(AFX), closed quotient, harmonic to noise ratio, jitter and shimmer) were investigated by Lx speech studio. Mean flow rate(MFR), subglottic pressure(Psub) and intensity were measured using the Phonatory function analyzer. The maximum phonation time was also measured. The data were statistically analyzed. A paired t-test (p<0.1) was used to compare preoperative and postoperative results. And multiple regression test was used to find which parameter was most correlated to improvement of postoperative voice quality. Results : Among aerodynamic parameters, Psub $(88.11mmH_2O{\rightarrow}58.7mmH_2O)$, MPT(7.87sec${\rightarrow}$12.53sec), MFR (359.8ml/sec${\rightarrow}$161.06ml/sec) were statistically improved. AFx(205.5Hz${\rightarrow}$163.27Hz), AQx(23.9%${\rightarrow}$48.3%), RAL, RAH. Jotter and shimmer were improved. In multiple regression test, AFx and AQx was noted as the two meost correlated parameters to improvement of postoperative breathiness. But general grade of voice quality was more correlated to Psub and shimmer. Conclusion : Vocal fold medialization procedures effectively reduce glottic gap. Increasing of contact area of both vocal folds induced improvement in aerodynamic parameters and leaded stabilizing of vocal fold vibration. That effect results in improvement in acoustic parameters (shimmer, jitter, signal-to-noise ratio, voice range profile) and voice quality.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.118-122
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• 2017

Background and Objectives : In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. Materials and Methods : This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. Results : Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), ${\Delta}$ jitter (p<0.001), ${\Delta}$ shimmer (p=0.031), and ${\Delta}$ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. Conclusion : Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.

• 말소리와 음성과학
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• 제12권4호
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• pp.91-98
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• 2020

근긴장성 발성장애(cepstral peak prominence, MTD) 환자의 모음 발성과 문장읽기 과제를 켑스트럼 기반 변수를 이용하여 분석하였으며 음성장애 환자의 GRBAS청지각적 특성과 음향학적 특성의 상관관계를 살펴보고, 랜덤포레스트 머신러닝 분류 알고리듬을 이용한 MTD 감별 진단 가능성을 논의하였다. 내원 시 MTD로 진단받은 여성 36명과 정상음성을 사용하는 여성 36명이 연구에 참여했으며, 수집한 음성샘플은 ADSVTM를 사용하여 분석하였다. 연구 결과, 음향학적 측정치 중 MTD의 CSID(cepstral spectral index of dysphonia)는 대조군보다 높았으며, CPP(cepstral peak prominence), CPP_Fo 값이 대조군보다 유의하게 낮았다. 이는 모음 발성과 읽기 과제에서 모두 동일하게 나타났다. MTD 환자의 음질 특성은 전반적인 음성중증도(G)가 가장 두드러졌으며, 조조성(R), 기식성(B), 노력성(S)순으로 음성 특성을 보였다. 이 특성이 높아질수록 CPP가 감소하는 부적 상관을 보이고, CSID는 증가하는 정적 상관이 관찰되었다. 켑스트럴 변수 중 모음과 문장읽기과제 모두에서 집단간 유의한 차이를 보여준 CPP와 CPP_F0를 이용하여 MTD와 대조군의 음성분류를 시도하였다. 머신러닝 알고리듬인 랜덤포레스트로 모델링한 결과 문장읽기 과제에서 모음연장발성보다 조금 더 높은 분류 정확도(83.3%)가 나왔으며, 모음 발성과 문장 읽기 과제 모두에서 CPP변수가 더 중심적 역할을 수행하였음을 알 수 있었다.