• 컴퓨터교육학회논문지
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• 제18권4호
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• pp.11-18
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• 2015

청력의 결여나 결손이 생기면 회화 음이나 환경 음을 청취하는 것이 어려우므로 언어 감각, 성격 등에 문제가 발생한다. 이러한 청각장애인들을 위하여 특별하게 발음 교정 교육을 할 수 있는 응용 프로그램을 설계하고 구현하였다. 시간과 장소에 제약이 없이 사용할 수 있도록 스마트폰 앱 형태로 제작하였고, 청각장애인의 발음 교정 실태를 고려하여 발음 습득 순서에 따라 난이도 순 훈련을 제공한다. 기본 발음 연습, 단어 발음 연습을 할 수 있고, 이에 대한 기록을 통하여 연습률과 성공률을 확인할 수 있다. 또한, 전면카메라를 통한 자가 발음 교정이 가능하도록 하여 발음이 향상되도록 하였다.

• 대한치과보철학회지
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• 제57권4호
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• pp.356-363
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• 2019

연구개를 포함한 상악골 절제술을 받은 환자는 구강, 비강, 상악동, 비인두를 포함하는 결손을 가질 수 있다. 비강과 구강이 개통되고 불완전한 구개인두폐쇄로 인해 공기 및 음식물이 누출되어 발음 장애, 저작, 연하 기능의 저하가 발생할 수 있고, 안모의 변형으로 환자의 심리상태에 부정적 영향을 줄 수 있다. 구개 폐색장치는 결손 부위 폐쇄를 통해 구강과 비강을 분리시켜 연하, 발음 및 심미적 장애를 개선할 수 있다. 완전 무치악 환자에서 구개 폐색장치는 통상적인 총의치와 같은 유지, 안정을 얻기 어렵기 때문에 결손 부위의 주위조직을 적절히 활용해 변연봉쇄를 얻어야 한다. 또한 hollow type bulb를 통해 보철물의 무게를 감소시켜 유지에 도움을 준다. 본 증례는 우측 편평상피암으로 인하여 상악골 절제술을 받은 63세 남환으로 구강 및 인두부의 기능적 변연형성을 통해 생리적으로 적절한 변연을 갖고, 이중온성법을 사용하여 무게를 감소시킨 보철물을 이용하여 기능적, 심미적 회복을 얻었기에 보고하는 바이다.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.557-562
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• 2006

Purpose: Advanced carcinoma of the tongue is a devastating disease which may cause severe speech or swallowing dysfunction. But, none to date has provided all of the complex functions of the tongue. The purpose of this study is to review our experiences with individuals who underwent glossectomy followed by reconstruction using free tissue transfer. Methods: Between February 1998 and February 2005, twenty-four patients underwent glossectomy followed by free tissue transfer reconstruction. The defects of tongue caused by partial or subtotal glossectomy were reconstructed by means of radial forearm or lateral thigh free flap with nerve innervation. Especially for the patients who underwent total glossectomy, we reconstructed deglutition muscles anatomically with nerve reinnervation, a procedure that allows the grafted muscle to maintain good tongue bulk without obvious atrophy. Results: Patients were reviewed to determine their functional outcome as it related to speech, deglutition, and aspiration. All patients achieved oral intake of a soft diet and acceptable speech. Conclusion: Although reconstruction following glossectomy using free tissue transfer is not ideal, this procedure is safe and reliable, and provides predictable results. A future challenge is the development of a surgical procedure for reconstruction of a tongue that maintains mobility and sensation using neurotized flaps.

• 한국음향학회:학술대회논문집
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• 한국음향학회 1994년도 제11회 음성통신 및 신호처리 워크샵 논문집 (SCAS 11권 1호)
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• pp.407-410
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• 1994

In this paper, we describe the new unsuperivised learning algorithm, SASOM. It can solve the defects of the conventional SOM that the state of network can't converge to the minimum point. The proposed algorithm uses the object function which can evaluate the state of network in learning and adjusts the learning rate flexibly according to the evaluation of the object function. We implement the simulated annealing which is applied to the conventional network using the object function and the learning rate. Finally, the proposed algorithm can make the state of network converged to the global minimum. Using the two-dimensional input vectors with uniform distribution, we graphically compared the ordering ability of SOM with that of SASOM. We carried out the recognitioin on the new algorithm for all Korean phonemes and some continuous speech.

• 대한기관식도과학회지
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• 제1권1호
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• pp.64-68
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• 1995

Vocal folds injury from vocal abuse is important topics of phonosurgery. Recent advances in diagnostic equipment, phonosurgery and speech analysis equipment have provided a lot of Information about fine movement of the vocal folds. However, predicting the reaction of the vocal folds to phonatory trauma remains difficult. The vocal folds need to withstand great vibratory and shearing stress and anchoring fibers of basement membrane Bone play a role in maintaining structural integrity of histologically different epidermis and superficial layer of lamina propria(cover of vocal folds). The purpose of this study is to demonstrate the changes of anchoring fibers in vocal polyp using transmission electron microscope. Various defects were observed : a irregular thickening of basement membrane, a near absence of normal anchoring fiber, a lot of electron dense material in superficial layer of lamina propria, a destruction of hemidesmosome and many vesicles carrying electron dense material In basal keratinocyte. These observations were suggestive of a hyperactivity of basal keratinocyte of vocal folds epithelium in response to vibratory stress.

• 대한치과교정학회지
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• 제23권2호
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• pp.179-197
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• 1993

Tongue posture at rest position of Class III malocclusion is very important in malocclusion and phonation. Because Class III malocclusion shoves low tongue position, speech defect is commonly occured. This study was attempted to evaluate the correlationship between the tongue posture at rest position and during /s/ phonation and facial skeleton in centric occlusion. Thirty subjects with Class III malocclusion who had no orofacial defects such as cleft palate, medical history of neurologic pathology, hearing defect and any previous speech therapy were selected. Ninety sheets of lateral cephalometric radiographs taken at rest position, during /s/ phonation and centric occlusion were traced, measured and statistically analysed. The results obtained were as follows ; 1. In Class III malocclusion, the posture of tongue was positively correlated with the position of hyoid body. The hyoid body was positioned anteriorly and inferiorly as the vertical facial skeleton was increased in centric occlusion. 2. In Class III malocclusion, the vertical position of tongue tip at rest position was not correlated with facial skeleton in centric occlusion, but the horizontal position had low correlation with mandibular body length, APDI, and $\underline{1}$ to SN. 3. In Class III malocclusion, there was the tendency that the dorsal position of the tongue was lowered as the vertical facial skeleton was increased. 4. In Class III malocclusion, the vertical and horizontal position of tongue tip during /s/ phonation was not correlated with facial skeleton in centric occlusion.

• 대한치과보철학회지
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• 제55권1호
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• pp.88-93
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• 2017

수술로 인한 상악골 결손 환자는 저작, 발음, 연하의 기능적 손상과 안모 변형으로 인한 어려움을 겪게 된다. 보철 치료의 목적은 폐쇄 장치를 통해 가능한 한 정상적인 기능과 안모를 회복하는 것이다. 이러한 목표는 재건에 대한 보철과 의사와 외과 의사의 술 전 의사소통을 통해 성취할 수 있다. 본 증례에서는 우측 상악동에 편평상피암 진단을 받은 환자에서 수술 전 치과 검진을 통해 보철적 재건에 대한 계획을 수립하였다. 상악골 절제술 4개월 후 수술용 폐쇄장치, 이행 폐쇄장치를 거쳐 최종 폐쇄장치를 제작하였다. 이를 통해 환자는 저작, 발음, 연하, 안모의 만족스러운 개선을 얻었기에 보고하고자 한다.

• 대한두개안면성형외과학회지
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• 제15권2호
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• pp.70-74
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• 2014

Background: Many options are available to cover a palatal defect, including local or free flaps. The objective of this study was to evaluate the usefulness of palatal mucoperiosteal island flap in covering a palatal defect after tumor excision. Methods: Between October 2006 and July 2013, we identified 19 patients who underwent palatal reconstruction using a palatal mucoperiosteal island flap after tumor excision. All cases were retrospectively analyzed by defect location, size, tumor pathology, type of reconstruction, and functional outcomes. Speech and swallowing functions were evaluated using a 7-point visual analog scale (VAS) score. Results: Among the 19 patients, there were 7 men and 12 women with an age range of 25 to 74 years (mean, $52.5{\pm}14.3$ years). The size of flaps was $2-16cm^2$ (mean, $9.4{\pm}4.2cm^2$). Either unilateral or bilateral palatal island flaps were used depending on the size of defect. During the follow-up period (mean, $32.7{\pm}21.4$ months), four patients developed a temporary oronasal fistula, which healed without subsequent operative. The donor sites were well re-epithelized. Speech and swallowing function scores were $6.63{\pm}0.5$ and $6.58{\pm}0.69$ on the 7-point VAS, indicating the ability to eat solid foods and communicate verbally without significant disability. Conclusion: The palatal mucoperiosteal island flap is a good reconstruction modality for palatal defects if used under appropriate indications. The complication rates and donor site morbidity are low, with good functional outcomes.

• Archives of Plastic Surgery
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• 제50권3호
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• pp.264-273
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• 2023

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.

• 대한치과보철학회지
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• 제55권3호
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• pp.319-324
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• 2017

상악골 부분 절제술을 시행한 많은 환자에서 안모의 변형으로 심리적 우울감에 취약할 뿐만 아니라 연하, 저작 기능이 저하되며 발음 장애가 발생한다. 폐색장치를 통한 악안면 보철적 치료는 저작, 연하, 발음 기능의 회복뿐 아니라 적절한 안모로 회복시켜주며 장치를 사용하는 환자들의 삶의 질을 향상해준다. 본 증례는 상악골 부분 절제술 시행한 환자에서 수술 부위 안정화 기간 사용한 임시 폐색장치로 적절한 안면 지지의 정도를 예측할 수 있었고 이를 반영하여 artificial palate를 제작하였다. 이는 적절한 안면 지지를 재현하여 최종 폐색장치를 제작하는 간단한 접근법을 제시하였고 기능적, 심미적 부분에서 만족할 만한 결과를 얻어 이를 보고하고자 한다.