• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.122-128
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• 2007

This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

• Speech Sciences
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• v.10 no.4
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• pp.189-200
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• 2003

The objective of this study was to examine two new parameters by which we could screen people with malignant vocal folds. The new parameters were the difference sums and Pearson correlation coefficients between adjacent pairs of intensity level matrices of narrow-band spectra. Audio files from the Korean Disordered Speech Database were analyzed by Praat, a speech analysis software, to obtain matrices of 400 intensity levels at 16 time points of each sustained vowel spectra. We limited our study to 12 normal subjects and 20 patients with malignant vocal folds who recorded at least three Korean vowels at a sound-proofed booth in Busan National University Hospital. Results indicated that the average coefficients of the abnormal subjects were much lower than those of the normal subjects while the average difference sums of the patients were much higher than those of the normal ones. Also, we found that the degree of the malignancy of the vocal folds was related to the coefficients and sums. However, some subjects at the initial stages of cancerous vocal folds yielded almost comparable coefficients and difference sums to those of the normal speakers. Further studies on larger databases will be desirable to set certain criteria or threshold levels for screening people with vocal fold diseases.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.5 no.1
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• pp.38-43
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• 1994

Though normal vocal cords show regular vibration, pathologic vocal cords show irregularity between peaks. Jitter means fluctuation in the time interval between peaks, and Shimmer means cycle to cycle variation in the amplitude of the peaks. We investigated the vocal vibration of Korean normal persons objectively. The fundamental frequency, Jitter, Shimmer and SNR(signal to noise ratio) of normal persons were compared with that of vocal Polyp Patients with CSpeech Program for the possibility of distinguishing the pathologic vocal vibration from normal. The results were as follows ; Comparing the fundamental frequency of vocal Polyp Patients with normal persons, great change was noted only in female cases. But the Jitter and Shimmer of vocal polyp patients were greater than normal significantly in both male and female cases. SNR was lower than normal in vocal polyp patients. In the conclusion, fundamental frequency, Jitter, Shimmer and SNR might be meaningful parameters distinguisuing pathologic vibration from normal.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.64-68
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• 2000

Background and Objectives : To assess the role of altered vocal function in transient voice change after short-term endotracheal intubation, we evaluated acoustic parameters, aerodynamic parameters, and laryngoscopic characteristics preoperatively and postoperatively. Materials and Methods : Vocal function of 10 patients undergoing tympanoplasty and mastoidectomy using general anesthesia and endotracheal intubation were studied preoperatively, at 1day and 7 days after extubation. Acoustic analysis, aerodynamic study, and telescopic examination were used to assess vocal function. Results : In acoustic parameters, there was no significant difference between preoperative and postoperative measures. However, in subglottic pressure, ere was a significant decrease at 1 day after extubation and this change was return to preoperative value at 7 days after extubation. MPT(Maximal Phonation Time), MER(Mean flow Ratio), and VC(Vital Capacity) were decreased 1 day after extubation but did not show statistically significant change. Three of 10 patients manifested a vocal fold edema and injection 1 day after extubation. Conclusions : Subglottic pressure revealed a significant decrease at 1 day after extubation. And this change was correlated with laryngeal morphologic change and decrement in pulmonary function.

• Phonetics and Speech Sciences
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• v.4 no.4
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• pp.147-154
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• 2012

The purpose of this study is to examine the effect of voice improvement when vocal training, which relaxes the vocal contact, is applied to children with vocal nodules. Subjects included 20 5- to 12-year-old boys with vocal nodules in Otolaryngology and for whom voice therapy had been advised. The vocal therapy was conducted for 40 minutes per a week for a total of eight times. Results were evaluated by videostroboscopy, auditory-perceptual evaluation of GRBAS Scale, aerodynamic test, and acoustic analysis before and after therapy. As a result, first, the size of vocal nodules was reduced and the unstable pattern of vocal contact was improved. Glottic closure was increased and Phase symmetry was decreased during vocal vibration. Mucosal wave was increased and muscle tension of the larynx was reduced. Second, auditory-perceptual evaluation showed that subjects' overall quality of voice improved. GRBAS Scale Evaluation showed that the characteristics of the subjects' voice which were rough, breathy, and strained and breathy were reduced after therapy. Third, the measurements of acoustic parameters showed a statistically significant improvement. The fundamental frequency of the subejects' voice was increased and values of Jitter and Shimmer, NHR, [H1-H2] decreased. Fourth, the maximum phonation time of children was increased. These results imply that vocal relaxation training conducted in this study has a very positive effect to improve the voice of children with vocal nodules.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.2
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• pp.154-163
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• 1999

GRBAS scale, the tool fir the perceptual evaluation of voice, demands the experience of judges, and MDVP parameters of CSL, the tool for the objective measurements of voice quality demands the exact interpretation of the analyzed results. The two tools should be used as compensatory evaluation methods, so the experimental study was performed to investigate the correlation between GRBAS scales and MDVP parameters by using the pathologic voice of the 30 patients with vocal polyps, and to know the significant MDVP parameters which the inexperienced GRBAS scale judges should attend to. The 30 subjects voices, saved in MDVP of CSL were analyzed by its own analysis program, and three experienced voice therapists judged the same voices by using GRBAS scales. The correlations between them were analyzed by Spearman Rank Correlation Coefficient. As results, among the 29 MDVP parameters, 22 parameters showed statistically significant correlation with Grade(G) scale(p＜0.05). And it was found that Roughness(R) scale showed significant correlation with 18 parameters, Breathiness(B) scale with 17 parameters, Strain(S) scale with 12 parameters. In Asthenicity(A) scale, no parameter showed significant correlation. On the whole, significantly high correlation were found in the parameters related with pitch ind amplitude perturbation, especially, the amplitude perturbation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.5-10
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• 1998

Voice rehabilitation is very important concerning in laryngectomees. Esophageal speech is a common and widely used method of voice restoration. But, until now there is no reliable data which shows the aerodynamic characteristics of esophageal speech. In order to evaluate the vocal quality of normal laryngeal and esophageal speech, several aerodynamic parameters were measured in 13 adults with normal laryngeal voice and 2 excellent esophageal speakers using Aerophone II voice function analyzer. The examined parameters were maximal flow rate, mean airflow rate, subglottic pressure, vocal efficiency, glottic resistance, maximal phonation time and mean sound pressure level. In vocal efficiency, there is no difference between two groups, but in other parameters, marked differences were showed in esophageal speakers, especially mean resistance. Results indicates that esophageal speakers make the efficient voices with poor aerodynamic condition, comparing with normal laryngeal speakers.

• Science of Emotion and Sensibility
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• v.16 no.1
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• pp.117-124
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• 2013

This study examined that how precisely MFCC, LPC, energy, and pitch related parameters of the speech data, which have been used mainly for voice recognition system could predict the vocal emotion categories as well as dimensions of vocal emotion. 110 college students participated in this experiment. For more realistic emotional response, we used well defined emotion-inducing stimuli. This study analyzed the relationship between the parameters of MFCC, LPC, energy, and pitch of the speech data and four emotional dimensions (valence, arousal, intensity, and potency). Because dimensional approach is more useful for realistic emotion classification. It results in the best vocal cue parameters for predicting each of dimensions by stepwise multiple regression analysis. Emotion categorizing accuracy analyzed by LDA is 62.7%, and four dimension regression models are statistically significant, p<.001. Consequently, this result showed the possibility that the parameters could also be applied to spontaneous vocal emotion recognition.

• Speech Sciences
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• v.8 no.4
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• pp.87-98
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• 2001

Vocal nodule is one of the representative chronic diseases of vocal folds, and it can be cured by surgical removal or voice therapy. The aim of this study is to evaluate the effect of the accent method, one of the popular effective voice therapy, in the patients with vocal nodule. Authors executed the accent method in 17 patients with vocal nodule who visited the Voice & Speech Therapy Clinic, Pusan National University Hospital analysed the voice before and after treatment using the local findings, acoustic analysis and aerodynamic analysis MPT. The voice was analysed with MDVP of CSL and MPT was checked using stop watch. The parameters included Fo, Jitter, Shimmer and noise to harmonic ratio(NHR) as acoustic analysis. The results were obtained as follows. In the evaluation by the local findings, it was improved to 77% in the patients of vocal nodule. Jitter and Shimmer were shown to be improved significantly. In particular, it was shown to be improved significantly in patients with vocal nodule. As the result of this study, the improvement of aerodynamic aspect was more statistically significant than that of acoustic parameters. When I generalized the above mentioned results, we suggest that it is a useful voice therapy which can be helpful to the improvement of voice, applying the accent method to the vocal nodule patients, and there are currently many methods to be used in the voice therapy, but it is thought which the accent method is the good treatment as the alternatives of keeping the continuous medical treatment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.112-116
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• 2015

Background and Objectives : Aerodynamic analysis is an examination which provides information regarding various vocalization measures indicating laryngeal efficiency. Voice evaluation using such examination must be capable of distinguishing between normal to abnormal voice. It also observes variables on aerodynamic characteristics by gender in regards to patients of vocal disorders, especially of vocal cord paralysis and vocal polyp, and compares the conditions before and after surgery. This paper therefore, seeks to build a framework for establishing standard levels of aerodynamical characteristic on vocal disorders. Subjects and Methods : The study was intended for a total number of 20 patients with vocal polyp or unilateral vocal cord paralysis. Those with the vocal polyp underwent laryngomycroscopy surgery and the vocal cord paralysis, vocal fold injection using Restylane. Aerodynamic analysis fulfilled the Maximum sustained Phonation (MXPH) and Voicing Efficiency (VOEF) by using PAS Model 6600 (KayPENTAX, USA). Results : In MXPH, increase in PHOT were evident with vocal polyp after surgery. As for patients with vocal cord paralysis, MAXDB, MEADB, DHODB, PHOT all have increased and MEAP, PEF, MEAF decreased after surgery. In VOEF, patients with vocal cord paralysis who underwent surgery showed increase in MAXDB, MEADB, DHODB, FET100, ARES, but decreases in PEF, TARF. Conclusion : Overall, it can be concluded that patients with the vocal polyp and vocal cord paralysis seemed to get closer to the normal values after than before surgery in majority of measures. This confirms that the function of their vocal cord has improved nearly to normality through operations.