• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.24-28
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• 2021

Background and Objectives Vocal polyp is one of the most common benign diseases of vocal fold caused by overuse of voice. Laryngeal microsurgery is the first treatment of choice for vocal polyp. However, surgery has many risks such as side effects of general anesthesia, injury of tooth and psychological burden. And we often experience reduction of vocal polyps without surgical procedure. The purpose of study is to evaluate the effect of non-surgical treatment such as vocal hygiene education and proton pump inhibitor (PPI) in patients with vocal polyp. Materials and Method We performed retrospective study for seventy-three patients of vocal polyp who treated with non-surgical modalities such as vocal hygiene education and PPI over three months. Treatment outcomes and risk factors such as age, sex, polyp size, position, symptom duration, presence of laryngopharyngeal reflux (LPR) symptoms, smoking history, voice abuse history and vocal hygiene education were evaluated by comparison between polyp size improved group and non-improved group. Results 5.5% of enrolled patients showed complete response and 23.3% showed partial response without surgery. Polyp size improved group significantly carried out more practice of vocal hygiene education treatment than the non-improved group (p=0.040). And the presence of LPR symptoms [hazard ratio (HR) 3.368, confidence interval (CI) 1.055-10.754, p=0.040] and not performing of vocal hygiene education (HR 3.664, 95% CI 1.078-12.468, p=0.038). Conclusion Vocal hygiene education can be a useful treatment option when making a decision to treat with vocal polyp.

• Phonetics and Speech Sciences
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• v.5 no.3
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• pp.83-93
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• 2013

Vocal hygiene education is an indirect training approach to improve vocal function by educating all facets of optimal vocal health. Satisfaction levels of participants might be an important component of this indirect therapy for voice disorders. The authors aimed to investigate the satisfaction levels of vocal hygiene education in 51 patients with voice problems. We classified voice disorders of the participants according to three etiological categories (subgroups): organic, neurogenic, and functional. The survey consisted of three parts: 1) a condition of vocal hygiene education, 2) a degree of satisfaction of the present education, and 3) a request for future education. Participants responded to each item of the survey using a five-point Likert scale of 1 to 5 (1 being not at all and 5 being extremely). They also wrote down personal comments of improvement. Participants scored the vocal hygiene education offered by the speech-language pathologists between '3' and '4'. Specifically, the participants were highly satisfied with the specific and comprehensible explanation/instruction given by their speech-language pathologists. However, they were less satisfied with the tuition fee for the therapy sessions. Vocal hygiene education is offered individually to people in a clinical setting. Our results support the notion that vocal hygiene education can be an integral aspect of the treatment of voice problems in most cases.

• Phonetics and Speech Sciences
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• v.5 no.4
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• pp.53-61
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• 2013

Voice disorders are most common in female teachers due to work-related vocal demands; however, only a few studies tried to evaluate individual risk factors with work-related risk factors to diagnose voice disorders. This study evaluated sixty-seven female elementary teachers (36 with voice disorders and 31 without voice disorders) to compare their vocal misuse, overuse, and vocal hygiene behaviors. Total Voice Handicap Index scores and VHI subscale (P, E, F) scores were not significantly different between two groups (p>0.05) and there was no relationship between VHI and acoustic measures (p>0.05). Loud talking, talking in noisy situations, and excessive speaking were significantly more frequent in female teachers with voice disorders (p<0.05) and thereby these overuse and misuse behavioral patterns were identified as risk factors to develop voice disorders in female teachers. Also, hydration was the most common behavior for vocal hygiene when experiencing vocal fatigue; however, hydration with hot green tea or coffee and throat clearing were often misused for vocal hygiene. This study found that female teachers from both groups presented higher voice handicap regardless of voice disorders. This study suggests a multidimensional voice assessment protocol is required to reflect voice problems in teachers and a vocal education program may be important to improve vocal hygiene knowledge and behavioral changes in female teachers.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.27-30
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• 2004

Background and Objectives : The purpose of the present study is to investigate the effect of vocal hygiene education for the female elementary school teachers. Materials and Method : Thirty healthy female elementary school teachers were enrolled for the study. We provided a vocal hygiene education to the half of them. Voice handicap index and acoustic parameters were measured before and 4 week after the education. The efficacy of vocal hygiene education was analyzed by Wilcoxon Signed-rank test. Results : The vocal hygiene group showed significant improvement both in the subjective and objective data after the education. However, the non-vocal hygiene group failed to show any improvement. In functional score, emotional score, jitter, shimmer, only Junior Class(JC) could find significant after the education. Only low career(LC) could find significant in subjective data. Conclusion : Vocal hygiene education may be useful in reducing vocal misuse and abuse associated with teaching, and can be an effective method to maintain and improve the vocal health of teachers.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.43-49
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• 2009

Vocal polyps are benign phonotraumatic lesions which are traditionally treated using phonomicrosurgical techniques. In the case of hyperfunctional voice use, voice therapy is effective and results in voice improvement. However, the utility of voice therapy about vocal polyp is in great demand. The purpose of this study was to evaluate the effects of voice therapy in patients with vocal polyps. The authors reviewed the medical records of 193 patients with vocal nodules or vocal polyps, and 64 patients (31 nodules and 33 polyps) were enrolled. All of the subjects had received explanation of problems, vocal hygiene education, and been treated by the $SKMVTT^{(R)}$ (Seong-Tae Kim's multiple voice therapy technique) ranging from 4 to 16 sessions (mean: 8.6 sessions). All subjects were examined by perceptual assessment, acoustic and aerodynamic measures, and VRP (voice range profile). In perceptual assessment, patients with vocal nodules had more breathy and strained voices than the vocal polyp group. Both groups significantly reduced rough, breathy voice after voice therapy. Patients with vocal polyps had worse voice quality than patients with nodules in acoustic measures. Both groups showed reduced jitter and shimmer after voice therapy. In aerodynamic measures, MPT and Psub were increased, and MFR was reduced (p<.05). Participants' frequency range and intensity range were increased after voice therapy, but only frequency range resulted in a significant difference (p<.05). In conclusion, the therapeutic effect of voice therapy in patients with vocal nodules and polyps was demonstrated perceptually and acoustically. We can suggest that voice therapy, including advice, vocal hygiene, and $SKMVTT^{(R)}$ is a useful as an initial choice of treatment for patients with vocal polyps before considering a surgical approach.

• Speech Sciences
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• v.13 no.3
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• pp.133-149
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• 2006

This study attempted to compare acoustic parameters, physiological observation and perceptual evaluation values obtained from the treatment and control groups in order to find out which of the self voice feedback therapies was better and which methods to train them were more effective. The experimental group carried out various self voice feedback therapies while the control group did only vocal hygiene. The acoustic measurement and voice manipulation for providing the patients visual, auditory feedback were done by a speech analysis software, Praat. The authors designed vocal hygiene, abdominal respiration and Praat self voice feedback therapies and applied them to 15 patients while applying only one vocal hygiene to 15 of the control group. For the purpose of examining the degree of their voice improvement after the treatment, pre- mid- and final evaluations were made for the two groups at the beginning, the 6th week and immediately after the 8th treatment session. Results of this study were as follows: The treatment group showed much improvement after receiving the voice treatment. In particular, acoustical and physiological indices from the optical endoscopy, pitch variation(Jitter), amplitude variation (Shimmer), maximum phonation time(MPT), and psychoacoustic evaluation showed statistically significant improvements over the control groups.

• Proceedings of the KSLP Conference
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• 1998.11a
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• pp.220-221
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• 1998

My experience in the treatment of vocal disorders among professional singers within the past year revealed the importance of vocal hygience for the maintenance of a better quality of voice. Therefore, the importance of vocal hygiene is discussed. (omitted)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.101-103
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• 2015

There are no standard consensus about treatment results and prognostic factors based on randomized trials for benign vocal fold lesion. Currently, voice therapy is the treatment of choice for vocal nodules, and laryngomicroscopic surgery is for vocal polyps. There are no strong evidences to support it, based on randomized controlled trials, But, it's just a consensus among laryngologist. Considering the pathophysiology of benign vocal cord lesions, cognitive behavioral therapy that corrects the patient's bad voice habits and improves their vocal hygiene could be most important factor for treatment outcomes.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.37-42
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• 2009

The purpose of the present study was to determine the effect of the management program known as vocal function exercise (VFE) on voice quality. Typical VFE was modified and applied to patients with vocal nodules by controlling intensity of voice and relieving the vocal fold to solve hyperfunctional problems in VFE. Eight female subjects aged between 28 and 54 who had been diagnosed with vocal nodules took part in the study. The patients performed VFEs once a week for eight weeks. Vocal function exercises consist of voice hygiene, respiratory training, phonation training, and glide training. The subjects' voices were analyzed pre and post therapy on the aspects of acoustics, maximum phonation time (MPT), GRBAS, and voice handicap index (VHI). As a result, it was found that fundamental frequency ($F_o$) was significant increased, shimmer decreased remarkably and that noise to harmonic ratio (NHR) lowered obviously in the acoustic parameter. In addition, MPT was increased significantly. The scale of GRBAS indicated significant improvement in grade, roughness, and strained voice. VHI indicated significant improvement in an emotional part. In conclusion, VFE was effective in improving voice quality for patients with vocal nodules.

• Speech Sciences
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• v.8 no.2
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• pp.39-48
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• 2001

The purpose of this study was to examine changes in acoustic characteristics after drinking alcoholic beverages and singing in order to establish guidelines for vocal hygiene of both singers and non-singers. 21 university students (10 males and 11 females) vocalized /a/ before drinking, after drinking and after singing. Changes in vocal range and acoustic characteristics were analyzed by Dr. Speech 4.0 (Tigers Electronics). No significant difference was observed in vocal range following drinking. However, there was statistically significant changes in vocal range after singing. We may infer that appropriate amount of singing functioning as vocal warm-up, rather than drinking alone, resulted in improvement in their abilities to lengthen vocal folds. This is directly related to the ability to produce high-pitched sounds. Changes in jitter in female voices after singing was the only acoustic factor that was significant. Changes in Shimmer and NNE was not significant either after drinking nor singing. Subjects who were judged to perform better in singing were marked by minimum acoustic changes, which may due to their well-trained vocal fold function. The results of this study may address the necessity for vocal function exercises for the patients with neurogenic voice disorders including dysarthria. The need for more extensive research with a larger number of subjects including professional voice users is also addressed.