• 대한후두음성언어의학회지
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• 제32권2호
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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.

• 말소리와 음성과학
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• 제16권2호
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• pp.49-58
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• 2024

본 연구에서는 정상음성사용자를 대상으로 음성검사를 위한 고가의 음성 녹음 장비인 Computerized Speech Lab(CSL) 대신 스마트폰에 적용 가능한 단일지향성 유선 핀마이크(WIRED), 스마트폰의 자체 내장 무지향성 마이크(SMART), 블루투스 무선 이어폰인 갤럭시 버즈2 프로(WIRELESS)로 녹음된 음성샘플의 음향학적 측정치를 비교하고자 하였다. 연구대상은 최근 3개월 이내 호흡기 질환으로 이비인후과에 내원한 적이 없는 정상성인 40명(남 12명, 여 28명)이었으며, 소음이 통제된 방음 부스에서 모음 /아/ 연장 발성(4초) 과제와 '산책' 문장, '가을' 문단 읽기 과제를 네 가지의 기기로 동시에 녹음하였다. 4종의 샘플들에 대하여 CSL 녹음을 기준으로 동기화 작업을 진행하였으며, MDVP와 ADSV, VOXplot 프로그램을 이용하여 분석하였다. 연구 결과, F0, shimmer, noise-to-harmonic ratio를 제외한 다른 변수들에서 유의미한 차이가 있었다. 특히 SR_V, SR_S, CSID_V, CSID_S, AVQI의 경우 CSL에 비해 WIRED의 CSID_V, CSID_S, AVQI 중증도가 낮았던 반면, SMART에서는 높게 나타났다. SR_V, SR_S의 경우 반대의 경향이 나타났으며, WIRELESS는 과제에 따라 다른 경향이 있었다. CSL과 다른 마이크 유형들은 동일한 변수 간에는 모두 양의 상관관계를 보였으며, F0와 CPP_V가 모든 유형에서 공히 강한 양의 상관관계를 보였다. ICC 또한 F0와 CPPV가 모두 0.9 이상으로 가장 높았다. 본 연구에서 사용된 마이크를 음향학적 분석을 위한 녹음 도구로 사용할 때, F0와 CPP_V의 경우 신뢰도 높은 분석 변수로 마이크 유형과 무관하게 포함할 수 있고, SR, CSID, AVQI의 경우 마이크 유형에 따라 분석 및 해석에 주의를 기울일 필요가 있을 것으로 판단된다.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.118-123
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• 2019

Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.

• 임상이비인후과
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• 제29권2호
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• pp.212-222
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• 2018

Background and Objectives : The purpose of this study was to compare the measured values of acoustic and auditory perceptual assessments between normal and functional dysphonia (FD) groups. Materials and Methods : 102 subjects with FD and 59 normal voice groups were participated in this study. Mid-vowel portion of the sustained vowel /a/ and two sentences of 'Sanchaek' were edited, concatenated, and analyzed by Praat script. And then auditory-perceptual (AP) rating was completed by three listeners. Results : The FD group showed higher acoustic voice quality index version 2.02 and version 3.01 (AVQIv2 and AVQIv3), slope, Hammarberg index (HAM), grade (G) and overall severity (OS), values than normal group. Additionally, smoothed cepstral peak prominence in Praat (PraatCPPS), tilt, low-to high spectral band energies (L/H ratio), long-term average spectrum (LTAS) in FD group were lower than normal voice group. And the correlation among measured values ranged from -0.250 to 0.960. In ROC curve analysis, cutoff values of AVQIv2, AVQIv3, PraatCPPS, slope, tilt, L/H ratio, HAM, and LTAS were 3.270, 2.013, 13.838, -22.286, -9.754, 369.043, 27.912, and 34.523, respectively, and the AUC of each analysis was over .890 in AVQIv2, AVQIv3, and PraatCPPS, over 0.731 in HAM, tilt, and slope, over 0.605 in LTAS and L/H ratio. Conclusions : In conclusion, AVQI and CPPS showed the highest predictive power for distinguishing between normal and FD groups. Acoustic analyses and AP rating as noninvasive examination can reinforce the screening capability of FD and help to establish efficient diagnosis and treatment process plan for FD.