• 말소리와 음성과학
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• 제5권3호
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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.

• 대한후두음성언어의학회지
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• 제32권1호
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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.

• 대한후두음성언어의학회지
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• 제15권1호
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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.

• 말소리와 음성과학
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• 제5권4호
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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.

• 말소리와 음성과학
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• 제1권2호
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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.

• 대한후두음성언어의학회지
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• 제31권1호
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• pp.13-18
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• 2020

Background and Objective The purpose of this study is to report the effect of voice therapy using the voice reinforcement method (VRM) in patients with vocal nodules. It is one of the holistic voice therapy methods for improving vocal mechanisms. VRM includes not only direct and indirect voice therapy, but also trial therapy and self-practice. Composed of four stages: vocal hygiene education, relaxation, reinforcement, and generalization. Materials and Methods The subjects were 13 patients who were diagnosed with vocal nodules. Acoustic analysis, auditory perceptual assessment, K-VHI-10 and nodules size were compared before and after voice therapy. Voice therapy was conducted by speech-language pathologist and the mean number was 4.2. Results In acoustic analysis, Jitter, vF₀, vAm, Shimmer, NHR, and VTI were significantly decreased. F₀ was increased after voice therapy for women. 'Grade', 'Rough,' and 'Breathy' were significantly decreased in the GRBAS scale after voice therapy. In addition, K-VHI-10 and nodules size were significantly decreased. Conclusion VRM seems to be an effective voice therapy method in vocal nodules treatment. In VRM, especially, trial therapy is given motivation for vocal nodules treatments and self-practice has a continuous therapeutic effect in everyday life. VRM can be also applied to the voice therapy for other hyper-functional dysphonia.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.49-55
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• 2020

Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

• 한국음향학회지
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• 제28권8호
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• pp.790-795
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• 2009

본 연구는 구개편도와 아데노이드 비대가 있는 아동이 구호흡을 하게 되면 만성적인 성대 건조를 유발하게 되고, 이러한 조건이 음질을 저하시킬 수 있을 것이라는 가설을 검증하기 위하여, 만 5세-8세의 정상 아동 68명과 구개편도와 아데노이드 비대아동 50명을 대상으로 MDVP 음성분석을 시행하였다. 연구 결과 정상 아동에 비하여 구개편도와 아데노이드 비대 아동은 Jitt, RAP, PPQ, Shim, APQ 파라미터에서 모두 통계적으로 유의미하게 높은 수치를 나타내어 낮은 음질을 보이고 있음을 알 수 있었다. 따라서 언어치료사나 이비인후과 전문의 등은 구개편도와 아데노이드 비대 아동의 음성문제 가능성을 인식하고, 이들의 음성위생법 교육에 관심을 가져야 할 것으로 여겨진다.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.128-132
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• 2008

Background: Laryngeal contact granuloma is an inflammatory hypertrophic granulation tissue arising at around the vocal process of arytenoid cartilage. Various approaches are currently used for the treatment, but a solid guideline has not been established. Objectives: We aimed to compare the each treatment modality in the hope of suggesting a guideline for the successful management of laryngeal contact granuloma. Method: Eighty-seven treatment cases of 56 patients were analyzed. Cases having recent intubation history were excluded from the study. All patients received vocal hygiene education. Proton pump inhibitors (PPI, N = 33) or H2 receptor antagonists ($H_{2}RA$, N =26) were used as a first-line treatment. Among the non-responders to $H_{2}RA$, 11 cases received PPI as a second-line therapy. Eight cases received botulinum toxin injection and 9 cases had laryngomicrosurgical removal. Results: As an initial therapy, response rate to PPI and $H_{2}RA$ was 60.6% and 38.5% respectively, which was not statistically different (p=0.091). Response rate of PPI as the second-line therapy was 36.3% (p=0.162 when compared to that of first-line PPI therapy). Response rate of Botulinum toxin injection was 75%. All cases of surgical removal recurred in a relatively short period (mean 1.9months). Conclusion: In patients having laryngeal contact granuloma, combined therapy with vocal hygiene education and PPI medication would provide more than 60% of therapeutic response. Botulinum toxin injection is highly effective even in non-responders to antireflux therapy. The only indications of surgery are to resolve diagnostic doubt or to treat acute airway compromise.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.10-15
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• 2004

Background and Objective : Voice disorders are one of the major occupational hazards of school teaching. Prolonged voice use through verbal instruction has been implicated as a cause of vocal impairment among members of this profession. They all depend on their voice for their livelihood and are greatly alarmed by slightest alteration in voice quality. Despite considerable research in the area of voice problems in teachers, the prevalence of voice disorders in this group is unknown. Severe voice problems can affect teacher's ability to teach in the classroom. Materials and Method : This study investigated the prevalence of self-reported voice problems in teachers using a survey of a simple random sample of middle school teachers (n=1000). As part of the survey, teachers were asked to report voice problems for the day of the survey, duration, main symptom, smoking, caffeine, alcohol history etc. Results : The reponse rate was 91%(n=94) with 89.7%(n=812) teachers reporting voice problems on the day of the survey, and 40%(n=330) of these group reporting the history of medical consult. Conclusion : These finding indicate a need for vocal hygiene education in teachers and for the development of educational programs aimed at preventing voice problems in this group of professional voice users.