• 말소리와 음성과학
• /
• 제3권3호
• /
• pp.133-140
• /
• 2011

Muscle misuse dysphonia (MMD) is defined as a behavioral voice disorder resulting from inappropriate contractions of intrinsic and/or extrinsic laryngeal muscles. The purpose of this study was to investigate the effect of motor learning guided laryngeal motor control therapy (MLG-LMCT) which is designed to improve an existing LMT and further the effective voice treatment on people with muscle misuse dysphonia. Forty-six people with MMD (M:F=16:30) participated in this study. The voice samples of the participants were recorded to investigate the effect of MLG-LMCT before and after the voice therapy. Voice samples were analyzed via electro-glotto-graph (EGG). Contact quotient (CQ), speed quotient (SQ), and waveform were reported. In addition, perceptual and acoustical evaluation were conducted to determine the change of voice improvement after treatment. The experimenter massaged the tensioned muscles around the neck. In order to find more proper phonation the experimenter showed the subjects their EGG wave forms as to whether or not they are moving the vocal folds to the appropriate position. Therefore, the EGG wave forms were used as a type of visual feedback. With the wave form, the experimenter helped subjects move the vocal folds and laryngeal muscles to find more proper voice production. The sensory stimuli from the experimenter gradually faded out. A paired dependent t- test revealed that there was significant differences in CQ between pre- and post-therapy. Perceptually, overall, rough, breathy, strain, and transition were significantly reduced. Acoustically, there were significant differences in Fo, jitter, shimmer, and NHR. After using MLG-LMCT, most of the subjects showed improvements in voice quality. The results from this study led us to the following conclusions: Motor learning guided laryngeal motor control therapy (MLG-LMCT) has reduces muscle misuse dysphonia. These results may occur because a visual feedback from EGG wave form can maintain the effect of the muscle tension reduction from laryngeal manual therapy. In case of people with MMD who reduced muscle tension from the therapy (LMT) but, not appropriately manipulating the location of larynx or adducting the vocal folds, MLG-LMCT might be an alternative therapy approach.

• 대한후두음성언어의학회지
• /
• 제17권2호
• /
• pp.127-132
• /
• 2006

Background and Objectives : Functional dysphonia is a voice disturbance in the absence of structural or neurologic laryngeal pathology characterized by voluntary misuse of laryngeal muscles. The present report reviews clinical characteristics of 25 patients with functional dysphonia. Materials and Method : We analyzed medical records, perceptual and acoustic analysis of voice samples, aerodynamic studies and laryngoscopy. Results : There was no sex or age predilection. Eighty four percent of patients presented sudden onset of symptoms and 76% had specific events at the onset. Most patients showed breathy or strained voice and various degree of vocal fold insufficiency with supraglottic compensatory contractions. Acoustic analysis revealed non-diagnostic, but mean flow rate was lower than normal in all cases. All patients responded to voice therapy except for 4 patients who were tort to follow up. Mean number of voice therapy sessions required to get responses is 1.9 sessions. Conclusion : We concluded that patients with functional dysphonia responded very well to short-term voice therapy and should be included in differential diagnosis in patients with dysphonia cannot be explained by structural or neurologic etiology.

• 대한후두음성언어의학회지
• /
• 제21권2호
• /
• pp.121-127
• /
• 2010

Background and Objectives : Unilateral vocal fold paralysis is generally treated using injection laryngoplasty or voice therapy. However, the decision of treatment method is dependent on clinician's preference and hospital facilities without specific criteria. The purpose of the study was to examine factors predictive of voice therapy outcome in patients with unilateral vocal fold paralysis. Materials and Method : 38 patients diagnosed as unilateral vocal fold paralysis, aged from 24 to 81 years and undergone voice therapy more than 1 month were included. After 3 to 12 (mean 5.1) sessions of voice therapy, subjects had divided into responder group (RG, 28 patients) and non-responder group (NRG, 10 patients) according to G scale change. Paramters of perceptual assessment, acoustic and aerodynamic measure, and videostroboscopy were compared between two groups, and factors predictive of voice therapy result were analyzed. Results : RG patients showed significantly reduced rough, breathy, asthenic voice after voice therapy. Change of MPT and MFR was more substantial in RG than in NRG. By videostroboscopy, RG patients showed significantly more mucosal wave symmetry, glottal closure, reduced glottal gap index during the closed phase of phonation, while NRG patients showed more occurrences of abnomal supraglottic activities during phonation (p < 0.05). Poor outcome of voice therapy significantly associated with increased asthenic scale, short MPT, and less glottal closure (p=0.02). In addition, 90% of patients with MPT more than 5 seconds were in RG, whereas 56% of patients with MPT less than 5 secondes were in RG. Conclusion : Voice therapy is useful for large proportion of patients with unilateral vocal fold paralysis as an initial treatment method. However, patients with large asthenia scale, large glottic gap or MPT less than 5 seconds tend to have poor voice therapy outcome, and early injection laryngoplasty maybe recommended for these patients.

• 말소리와 음성과학
• /
• 제10권4호
• /
• pp.91-99
• /
• 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
• /
• 제7권1호
• /
• pp.11-17
• /
• 2015

This paper deals with the correlation between physical fatigue and speech signals. A treadmill task to increase fatigue and a set of subjective questionnaire for rating tiredness were designed. The results from the questionnaire and the collected bio-signals showed that the designed task imposes physical fatigue. The t-test for two-related-samples between the speech signals and fatigue showed that the parameters statistically significant to fatigue are fundamental frequency, first and second formant frequencies, long term average spectral slope, smoothed pitch perturbation quotient, relative average perturbation, pitch perturbation quotient, cepstral peak prominence, and harmonics to noise ratio. According to the experimental results, it is shown that mouth is opened small and voice is changed to be breathy as the physical fatigue accumulates.

• 대한후두음성언어의학회지
• /
• 제31권2호
• /
• pp.66-70
• /
• 2020

Background and Objectives Presbyphonia is characterized by hoarse, breathy, weak vocal intensity. Extracellular matrix (ECM) in lamina propria (LP) of the vocal folds play an important role in voice production, and change of ECM according to the aging leads to the presbyphonia. The aim of this study was to investigate the histologic analysis of aging vocal fold of rat. Materials and Method Six and twenty two months old Sprague-Dawley rats (n=8, each group) were used and classified into young (six months old rats) and old (twenty two months old rats) group. Histologic analysis and immunohistochemical staining for ECM of LP were performed. Results Overall cellular density was significantly decreased in old rat group. Elastin fibers of LP were significantly decreased in old rat group. Type I collagen was significantly increased in old rat group. Type III collagen did not show significant difference. Hyaluronic acids did not show significant difference in Alcian blue staining and immunohistochemical staining. Conclusion Decreased general cellular density and elastin fiber and increased type I collagen were observed in the LP of vocal folds of aging rats. These ECM changes might to contribute the aging voice.

• 말소리와 음성과학
• /
• 제15권4호
• /
• pp.81-90
• /
• 2023

청지각적 평가 및 음향학적 분석은 음성평가를 위해 임상 현장에서 일반적으로 사용해오고 있다. 본 연구는 음성장애 환자의 청지각적 및 음향학적 측정 시 말 과제 효과를 조사하고자 한다. 음성장애로 진단받은 총 22명의 환자로부터 모음연장발성(/a/, /e/, /i/, /o/, /u/, /ɯ/, /ʌ/)과 연속구어('가을'표준문단의 9개 하위문장)를 녹음하였다. 음성장애 평가 및 치료 경험이 있는 2명의 음성언어치료사가 맹검 및 무작위 음성 샘플을 사용하여 GRBAS('G', 'R', 'B', 'A', 'S')척도 및 CAPE-V('OS', 'R', 'B', 'S', 'P', 'L')를 사용하여 청지각적 평가를 실시하였다. 또한, ADSV(analysis of dysphonia in speech and voice model)를 이용하여 켑스트럼 및 스펙트럼 측정치를 구하였다. 모음 유형에 따라 GRBAS 척도에서 'B'를 제외하고 청지각적 평가에 영향을 미치지 않았으나, CAPE-V에서는 'OS', 'R', 'B'에 영향을 미쳤다(p<.05). CPP 및 L/H ratio 는 모음 유형과 문장 위치의 영향을 받았다. 표준문단의 CPP값은 모든 모음에서 'G', 하위 9문장과 유의미한 부적 상관 관계가 나타났고, 특히, /e/모음(r=-.739)에서 가장 높은 상관관계를 보였다. 두 번째 문장의 CPP는 모든 모음과 높은 상관관계를 보였다. CAPE-V는 말 자극에 따라 GRBAS보다 청지각적 평가에 더 많은 영향을 받을 수 있으며, 'B' 척도, CPP, L/H ratio는 모음 유형과 자음을 포함한 문장 위치에 따라 영향을 받았다. 따라서, 음성 장애 환자의 음성 평가에서 모음을 사용할 때는 /a/뿐만 아니라 ' 기식성'음질과 음향적으로 상관성이 높은 /i/모음을 함께 사용하는 것이 유용할 수 있다. 또한 /e/모음은 한국 표준문단 '가을' 및 하위 문장들과 음향적으로 상관성이 높았으므로 문단 대신 사용할 수 있을 것이다. 또한, 음성장애 신호들이 대부분 비주기적이라는 점을 감안할 때, CPP와 함께 표준문단 중 가장 음향적으로 상관성이 높은 두 번째 문장을 사용할 수 있을 것이다. 이러한 결과는 말과제가 청지각적 평가 및 음향학적 측정에 미치는 영향에 대한 임상적 증거를 제공하며, 이는 음성장애 환자의 음성 평가에 대한 가이드라인을 제공하는 데 도움을 줄 수 있을 것이다.