• 대한후두음성언어의학회지
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• 제9권1호
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• pp.22-26
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• 1998

Uvulopalatopharyngoplasty(UPPP) is one of the most popular surgical procedure for the treatment of obstructive sleep apnea syndrome(OSAS) occurring at the level of oropharynx. However, voice changes after UPPP have been a challenging issue for the professional voice users, because even minor changes in voice quality or articulation may be critical to professional singers, teachers, and so on. Several acoustic changes after UPPP have been proposed. However, based on the authors understanding, there is no report about voice changes after UPPP in Korean. We measured the first, second and third formant frequencies of /a/, /i/, /u/ phonations in 20 adult male patients who had undergone UPPP surgery, and the nasalances of Rabbit, Baby, and Mama passages. These parameters were measured preoperatively, at 1 month and 3 months after the operation. Any subjective voice changes were asked to be reported at the posto-perative visits. The third formant(F3) of /u/ phonation was significantly reduced at postoperative 1 month measurement. The nasalance of Mama passage was singnificantly increased at postoperative 3 months measurement. No one complained of subjective changes in voice quality, timbre, articulation or speech. Even though there are no complaints about postoperative voice changes subjectively, significant changes in the formant characteristics of certain vowel and changes in the nasality after UPPP require the clinicians to be mort cautious and careful in deciding UPPP for the professional voice users.

• 음성과학
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• 제4권2호
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• pp.69-89
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• 1998

The aim of this study is to develop an objectively method of speech evaluation for children with cleft palates. To assess velopharyngeal function, Visi-Pitch, Computerized Speech Lab. (CSL), Nasometer and Palatometer were used for this study. Acoustic parameters were measured depending on the diagnostic instruments: Pitch (Hz), sound pressure level (dB), jitter (%) and diadochokinetic rate by Visi-Pitch, VOT and vowels formant ($F_1\;&\;F_2$) by a Spectrography and the degree of hypernasality by Nasometer. In addition, Palatometer was used to find the lingual-palatal patterns of cleft palate. Ten children with cleft palates and fifty normal children participated in the experiment. The results are as follows: (1) Higher nasalance of children with cleft palates showed the resonance disorder. (2) The cleft palate showed palatal misarticulation and lateral misarticulation on the palatogram. (3) Children with cleft palates showed the phonatory and respiratory problems. The duration of sustained vowels in children with cleft palates was shorter than in the control groups. The pitch of children with cleft palates was higher than in the control groups. However, intensity, jitter and diadochokinetic rate of children with cleft palates were lower than in the control group. (4) On the Spectrogram, the VOT of children with cleft palates was longer than control group. $F_1\;&\;F_2$ were lower than in the control group.

• 음성과학
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• 제2권
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• pp.67-88
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• 1997

The aim of this study is to develop an assessment program of speech rehabilitation for children having some language and speech disorders. Patients of dysarthria, tonsillectomy, tonsilhypertrophy, and nasal obstruction were selected for this experimental clinical phonetic study. Formant variations ($F_1\;&\;F_2$) show pre- and post-operation differences in tonsillectomy and cleft palate patients. Nasal formants ($NF_1\;&\;NF_2$) show pre- and post-operation differences in nasal obstruction. The articulation reaction time (ART) as a parameter was used to assess Voice Onset Time(VOT). It was shown longer duration for hypokinetic dysarthria and shorter for atoxic dysarthria.. The diadochokinetic rate was measured by Visi-pitch. Lower diadochokinetic rate appeared to spastic and dysarthria in comparison with the control group. It was shown that the nasalance of tonsilhypertrophy, nasal obstruction, and cleft palate patients was seen to increase after operation. In addition, the assessment of nasality can be measured only by simple vowels such as /a/ and /i/.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.5-9
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• 2004

Some patients who have undergone adenotonsillectomy (AT) or tonsillectomy(T) complain of voice change. Research was designed to determine the relationship between subjective voice change and change of parameters in boice analysis and to find the degree of voice change according to age and excised tissue volume. In 34 patients who underwent AT and 17 patients who underwent T, we measured the masalance, the fundamental frequency of /a/phonation and the formants and bandwidths of /a/, /i/, /u/ phonations. These parameters were measured preoperatively and also 7 days after the operation. Excised tissue volume was measured on operation. Postoperative changes were statistically analyzed. Any subjective voice change was asked to be reported at the visit 7 days after the operation. There was analysis for the difference of above parameters between some who answered "voice change" (A group) and the others who answered "no voice change" (B group). 24 patients(71%) who underwent AT and 4 voice change. Nasals nasalance change is an important factor in subjective voice change after AT.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.25-30
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• 2012

Background : The soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate. Methods : Six patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools: nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation. Results : Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%). The mean score of the speech acuity test was 5.84 (range, 5 to 6). These mean ratings represent a satisfactory level of speech function. Conclusions : The large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제55권8호
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• pp.498-507
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• 2012

Background and Objectives We aimed to develop a Korean version of the velopharyngeal insufficiency (VPI) speech corpus system. Subjects and Method After developing a 3-channel simultaneous speech recording device capable of recording nasal/oral and normal compound speech separately, voice data were collected from VPI patients aged more than 10 years with/without the history of operation or prior speech therapy. This was compared to a control group for which VPI was simulated by using a french-3 nelaton tube inserted via both nostril through nasopharynx and pulling the soft palate anteriorly in varying degrees. The study consisted of three transcriptors: a speech therapist transcribed the voice file into text, a second transcriptor graded speech intelligibility and severity and the third tagged the types and onset times of misarticulation. The database were composed of three main tables regarding (1) speaker's demographics, (2) condition of the recording system and (3) transcripts. All of these were interfaced with the Praat voice analysis program, which enables the user to extract exact transcribed phrases for analysis. Results In the simulated VPI group, the higher the severity of VPI, the higher the nasalance score was obtained. In addition, we could verify the vocal energy that characterizes hypernasality and compensation in nasal/oral and compound sounds spoken by VPI patients as opposed to that characgerizes the normal control group. Conclusion With the Korean version of VPI speech corpus system, patients' common difficulties and speech tendencies in articulation can be objectively evaluated. Comparing these data with those of the normal voice, mispronunciation and dysarticulation of patients with VPI can be corrected.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.202-209
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• 2017

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ${\geq}17$ years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.