• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.52-56
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• 2009

Background and Objectives : Vocal nodule is common inflammatory vocal cord lesion which could be improved by voice rest or voice therapy. But some patients, who do not have any improvement after voice therapy, should take laryngomicorsurgery or additional long-term voice therapy. So we try to find prognostic factors which affect the results of voice therapy. Materials and Methods: There are 36 patients (response group) whose symptoms improved after initial voice therapy and 16 patients (no response group) whose symptoms did not improve at all. We compared clinical features (durations of symptoms, voice abuse, laryngopharyngeal reflux), GRBAS scale, acoustic analysis, aerodynamic analysis and voice handicap index between the two groups from January, 2006 to June, 2008. Results: Response group underwent voice therapy 4.5 times (ave.) and no response group underwent 6.7 times (ave.). No response group has longer duration of symptoms, higher GRBAS scale score, higher NIH ratio, and higher MFR than those of response group. Conclusion : This study found that the prognosis of voice therapy in patients who have longer duration of symptoms, high NIH ratio, and bad perceptional test result is not likely to be good. In those cases, we should recommend earlier surgery, voice therapy after surgery, and inform about the necessity of long-term voice rehabilitation or voice therapy in order to get favorable compliance.

• 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.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.292-294
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• 2007

This study was designed to compare the translated patient's subjective rating scales for voice evaluation (Voice Handicap Index; VHI, Voice-Related Quality of Life; V-RQOL, Voice Rating Score; VRS) into Korean, taken from 24 professional voice users diagnosed with organic voice disorders. First, the correlation amongh those scales were observed. Second, the correlation between the patient's subjective rating scales and acoustic measures (Jitter%, Shimmer%, NHR) were examined. Third, those scales were compared by clinician's objective scale (G in GRBAS scale). Results indicated that significant correlations among the patients' subjective rating scales and significant correlations of clinician's rating scale with jitter% and Shimmer%, but not with NHR were observed. In addition, there were significant correlations of G with VHI and VHI-P (one of subscale of VHI). However, none of acoustic measures were correlated with the patient's subjective rating scales.

• Phonetics and Speech Sciences
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• v.5 no.1
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• pp.63-69
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• 2013

This study attempted to investigate the characteristics of Phonation Threshold Pressure and Phonation Threshold Airflow of Patients who have Functional voice disorder. 50 subjects participated in study (32 subjects were patients who had functional voice disorders and 20 subjects were normal adults). The PAS (Phonatory aerodynamic system, model 6600, KAY electronics, Inc.) was used to measure the data and to do the analysis. Data from the Phonation Threshold Pressure was measured using voicing efficiency of the PAS protocol. Data from the Phonation Threshold Airflow was measured using Maximum Sustained Phonation of the PAS protocol. Those were used because of the ease of phonation. The results of this study showed that the differences in Phonation Threshold Pressure and Phonation Threshold Airflow between patients who had functional voice disorder and normal adults could be significant index. Patients who had functional voice disorder showed more higher figures than normal adults. These results suggest that Phonation Threshold Pressure and Phonation Threshold Airflow are very useful in diagnosing the voice disorder. The measured data also provided useful information for diagnosing patients with vocal fold diseases.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.137-142
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• 2011

Background and Objectives : The aim of this study is to introduce Korea version of pediatric VHI and to compare pVHI-K scores between children with dysphonia and children without voice problems before pVHI-K is developed as a preliminary study. Additionally, the relationship between pVHI and acoustic measures were investigated. Materials and Methods : pVHI-K scores in normal group were obtained from 15 parents who have children with no present or past history of a voice disorder, hearing loss, or related disability that can affect the their voice or speech. Dysphonia group consisted of 15 parents who have children with bilateral vocal fold nodule's at Department of Otolaryngology, the Seoul National University Hospital (SNUH). pVHI-K and acoustic parameters were measured in two group. Results : The mean pVHI scores (total, functional, physical, emotional) in normal group were 2.33 (T), 0.80 (F) 1.33 (P) and 0.27 (E), respectively whereas those of pVHI in children group with dysphonia were 23.13 (T), 11.07 (F), 5.73 (P) and 6.13 (E), respectively and significant differences were revealed in total pVHI score as well as in all of the sub-pVHI scores. Moreover, significant correlation between pVHI-K parameters (T, F, P) and acoustic measures [Shimmer(%)] were shown in children in dysphonia group. Conclusion : Reported by parents can be useful as a supplementary clinical tool for diagnosing and measuring treatment effectiveness in young children with dysphonia.

• Journal of Sasang Constitutional Medicine
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• v.33 no.4
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• pp.1-9
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• 2021

Objectives The purpose of this study was to check whether the classification of the individual's Body Mass Index (BMI) could be predicted by analyzing the voice data constructed at the Korean medicine data center (KDC) using machine learning. Methods In this study, we proposed a convolutional neural network (CNN)-based BMI classification model. The subjects of this study were Korean adults who had completed voice recording and BMI measurement in 2006-2015 among the data established at the Korean Medicine Data Center. Among them, 2,825 data were used for training to build the model, and 566 data were used to assess the performance of the model. As an input feature of CNN, Mel-frequency cepstral coefficient (MFCC) extracted from vowel utterances was used. A model was constructed to predict a total of four groups according to gender and BMI criteria: overweight male, normal male, overweight female, and normal female. Results & Conclusions Performance evaluation was conducted using F1-score and Accuracy. As a result of the prediction for four groups, The average accuracy was 0.6016, and the average F1-score was 0.5922. Although it showed good performance in gender discrimination, it is judged that performance improvement through follow-up studies is necessary for distinguishing BMI within gender. As research on deep learning is active, performance improvement is expected through future research.

• Korean Journal of Head & Neck Oncology
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• v.32 no.1
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• pp.7-11
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• 2016

Background and Objectives: Quality of voice may be deteriorated after thyroidectomy without any injury to recurrent laryngeal nerve. While there have been several studies showing the change of acoustic parameters after thyroidectomy, factors related to deteriorated voice quality have been rarely studies. In this study, we sought to analyze the factors associated to deteriorated voice quality after thyroidectomy. Materials and Methods: We made a retrospective review of 35 patients who underwent thyroidectomy for papillary thyroid carcinoma. Voice analysis including acoustic analysis, voice handicap index 10 (VHI-10), and GRBAS score was conducted before and 3 months after surgery. Patients were grouped according to the amount of increase in VHI-10 after surgery ; group A (${\Delta}VHI<7$) and group B (${\Delta}VHI{\geq}7$). Clinicopathologic factors associated to patients of group B were analyzed and changes of parameters from acoustic analysis in each group were evaluated. Results : Patients of group B were associated with age ${\geq}45$ years (p=0.025) and showed borderline association to total thyroidectomy (p=0.075) and tumor size ${\geq}1cm$ (p=0.086). Multivariate analysis demonstrated that those with age ${\geq}45$ years were independently associated to deteriorated quality of voice (p=0.014, HR=18.38). Patients of group B were also associated to significant deterioration of high pitch (p<0.001) and Grade score with borderline significance (p=0.054). Conclusion: Patients older than 45 years may have higher risk of deterioration of quality of voice after thyroidectomy based on increase of VHI-10 score (${\Delta}VHI{\geq}7$). Association with deterioration of high pitch should also be considered in these patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.23-27
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• 2005

Background and Objectives : Voice disorders can cause problems in patients with benign vocal cord lesions emotionally, physically, economically and functionally. Neither subjective nor objective voice examinations can evaluate such factors adequately. The Voice Handicap Index (VHI) subjectively evaluates voice disorders in terms of physical, functional, emotional factors and measures the patient's perception of the impact of voice disorder. The purpose of this study is to evaluate the usefulness of VHI in the patients with benign vocal cord lesions. Materials and Method : The authors evaluated 37 patients who experienced laryngeal microsurgery for benign vocal cord lesions from september 2003 to August 2004. The VHI was used to measure the postoperative changes of the patient's perception and acoustic analysis and aerodynamic tests were also done. Statistical analysis was done using paired t-test and Pearson's correlation. Results : The VHI scores showed statistically significant reductions postoperatively. In acoustic analysis, jitter and shimmer had statistically significant reductions after surgery but noise-to-harmonics ratio did not. A statistically significant change in the average MFR and MPT perioperatively was found. The relationship between VHI and acoustic, aerodynamic analysis attained statistical significance. Conclusion : The VHI is a useful assessment tool to monitor the patient's self-perception of voice change after the surgery of benign vocal cord lesions. The VHI measurement, when combined with acoustic and aerodynamic analyses, will be helpful in comparing functional outcomes after voice surgery.

• Phonetics and Speech Sciences
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• v.6 no.3
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• pp.3-12
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• 2014

Larynx plays an important role in phonation and protection of the respiratory tract during swallowing. The reduced anatomical and physiological function in elevation of larynx and glottis closure can cause problems in voice and swallowing. The present study investigated the Korean version of handicap index of dysphagia in elderly Koreans. Therefore, 60 normal elderly Koreans ranged from 65 to 95 and 20 normal Korean young adults aged from 20 to 25 were participated in this study to compare total (T), physical (P), functional (F), and emotional (E) index scores between two groups as well as among sub groups (60s, 70s, 80s) in elderly. For swallowing, total and sub dysphagia handicap index (DHI) scores, voice quality during /a/phonation following swallowing (saliva and water), intensity of coughing, and L-DDK were measured. The results showed that functional (P), physical (P), emotional (E) scores as well as total (T) score were significantly different between young adults and old adults in DHI(p<.05). Additionally, there was a negative correlation between total DHI score and intensity of coughing (r=-.51) as well as L-DDK (r=-.70). These findings suggest that a slow rate in vocal fold adduction and reduced intensity of coughing in the elderly affect swallowing function. Thus, recently translated Korean version of DHI may be useful as supplement in evaluating the swallowing problems in elderly people.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.84-88
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• 2017

Background and Objectives : The purpose of this study was to compare the usefulness of Cepstral peak prominence (CPP) with parameter of Multiple Dimensional Voice Program (MDVP) in evaluating unilateral vocal fold paraylsis patients with subjective voice impairment. Materials and Methods : From July 2014 to August 2016, 37 patients with unilateral vocal fold paralysis who had been diagnosed with unilateral vocal fold paralysis and had received two or more voice tests before and after the diagnosis were evaluated for maximum phonation time (MPT), MDVP and CPP. Respectively. Voice tests were performed with short vowel /a/ and paragraph reading. Results : The CPP-a (CPP with vowel /a/) and CPP-s (CPP with paragraph reading) of the Cepstrum were statistically negatively correlated with G, R, B, and A before the voice therapy. Jitter, Shimmer, and NHR of MDVP were positively correlated with G, R, B. Jitter, Shimmer, and NHR of the MDVP were significantly correlated with the Cepstrum index. G, B, A and CPP-a and CPP-s showed a statistically significant negative correlation and a somewhat higher correlation coefficient between 0.5 and 0.78. On the other hand, in MDVP index, there was a positive correlation with G and B only with Jitter of 0.4. Conclusion : CPP can be an important evaluation tool in the evaluation of speech in the unilateral vocal cord paralysis when speech energy changes or the cycle is not constant during speech.