• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.164-172
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• 2002

The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

• Phonetics and Speech Sciences
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• v.1 no.1
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• pp.93-98
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• 2009

The aim of this study was to investigate voice characteristics of adductive spasmodic dysphonia(ADSD) by measuring electroglottal and acoustic examination at the sentence level. The clinical records of 86 ADSD female patients (age group of $20{\sim}50$ years) and the control records of 86 normal females (age group of $20{\sim}40$ years) were recorded by speech studio(Laryngograph Ltd., UK). An independent t-test was used to compare ADSD and normal group. Results were as follows. (1) Fundamental frequency($F_0$) was significantly decreased in ADSD compared with normal group. (2) Irregularity of frequency and closed quotient(CQ) was significantly increased in ADSD compared with normal group. (3) Voiceless duration increased and voiced duration was significantly decreased in ADSD compared with normal group. (4) Fricative duration was increased in ADSD compared with normal group but it wasn't significant. In conclusion, strained, tight and choked voice shows an increase of CQ, tremor voice shows an increase of irregularity of frequency and less feminine voice shows decrease of $F_0$. Increase of voiceless duration and fricative duration and decrease of voiced duration related with diminution speech intelligibility.

• Proceedings of the KSLP Conference
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• 2009.03a
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• pp.19-19
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• 2009

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.82-86
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• 2019

In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.46-50
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• 2015

Background and Objectives:Laryngeal hyperkinetic movements of stuttering patients is similar to that of adductor spasmodic dysphonia. There has been studies on implementing botulinium toxin injections to treat stuttering. However, the opinions on the bouolinium toxin injection's effects on stuttering patients vary. In this study authors aim to figure out when the botulinium toxin injection improves stuttering patients. Materials and Methods:Stuttering patients who could receive botulinium toxin injection participated in this study. Age differences, gender differences, electroglottogrphic test, aerodynamic test in botulinium toxin injection treatment of stuttering were analyzed. Results:The botulinium toxin injection had statistically significant impact on patients who showed low mean air flow rate during aerodynamic study. Conclusion:The botulinium toxin injection could reduce stuttering of patients with low mean air flow rate in aerodynamic study.

• Journal of Genetic Medicine
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• v.12 no.1
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• pp.19-24
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• 2015

Speech and language are uniquely human-specific traits, which contributed to humans becoming the predominant species on earth. Disruptions in the human speech and language function may result in diverse disorders. These include stuttering, aphasia, articulation disorder, spasmodic dysphonia, verbal dyspraxia, dyslexia and specific language impairment. Among these disorders, stuttering is the most common speech disorder characterized by disruptions in the normal flow of speech. Twin, adoption, and family studies have suggested that genetic factors are involved in susceptibility to stuttering. For several decades, multiple genetic studies including linkage analysis were performed to connect causative gene to stuttering, and several genetic studies have revealed the association of specific gene mutation with stuttering. One notable genetic discovery came from the genetic studies in the consanguineous Pakistani families. These studies suggested that mutations in the lysosomal enzyme-targeting pathway genes (GNPTAB, GNPTG and NAPGA) are associated with non-syndromic persistent stuttering. Although these studies have revealed some clues in understanding the genetic causes of stuttering, only a small fraction of patients are affected by these genes. In this study, we summarize recent advances and future challenges in an effort to understand genetic causes underlying stuttering.

• Speech Sciences
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• v.10 no.1
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• pp.143-152
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• 2003

The present study was performed to investigate change in shimmer according to $F_{0}$ variation precisely, and to offer suggestions for a clinical application. The analysis for the present study was done by the fundamental frequency ($F_{0}$) and shimmer measurement results of the previous 120 Korean normal adults' voice study of Pyo et al. (2002), used three vowels, /i/, /a/, /and /u/. Through the analysis of 60 female samples from the previous study, we found that $F_{0}$ of the vowels was the highest in /u/, and the lowest in /a/, but, on the contrary, shimmer was highest in /a/and lowest in /u/. Thirty of 60 subjects showed such an inverse relationship between $F_{0}$ and shimmer, as a whole. In the vowel /a/, 47 of 60 subjects showed the increased $F_{0}$ and decreased shimmer, in /i/, 32 subjects, and in /u/, 33 subjects showed the same results. The decrease in shimmer means the improvement of voice quality, so by these results, we expect to answer the question why the patients with spasmodic dysphonia can improve their voice quality with increased pitched voice production.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.2
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• pp.90-95
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• 2013

Botulinum toxin, a neurotoxin, is known to be an inhibitor of cholinergic neuromuscular transmission. Recently, it was reported that the administration of botulinum toxin is effective for the treatment of focal neurological motor disorders such as cervical dystonia, blepharospasm, hemifacial spasm, spasmodic dysphonia, and writer's cramp. Several case studies reported that the botulinum toxin was administered for the treatment of motor tic or vocal tic. It was found that this toxin reduces the frequency and severity of the tic as well as the premonitory urge and symptoms. In our case study, a noticeable decrease of motor tic symptom was observed after an intramuscular injection of 300mg of botulinum toxin in an 18-year-old patient with Tourette's disorder who showed only a little improvement of motor tic and vocal tic symptoms after treatment with antipsychotic drugs for several years. This case is reported in our study and literature survey was undertaken for reviewing similar cases. In our study, an 18-year-old boy diagnosed with Tourette's disorder based on Diagnostic and Statistical Manual of Mental Disorders, fourth edition presented with the following scores : the Clinical Global Impression scale, Yale Global Tic Severity Scale (motor/vocal/severity), Premonitory Urge Score, Korean Attention-Deficit Hyperactivity Disorder Rating scale, and Kovac Depression scale which were performed prior to the treatment were 5, 21/5/50, 100, 17, and 18 points, respectively. Two weeks after the injection of botulinum toxin, the scores were 4, 17/5/40, 50, 16, and 19 points, respectively. Eight weeks after the injection of botulinum toxin, they had become 3, 15/5/30, 25, 16, and 20 points, respectively, which clearly indicates a noticeable decrease of motor tic symptom.