• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.1
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• pp.22-27
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• 2001

Backgrounds and Objectives : There have been reported many studies which evaluate the effectiveness of combined laryngomicrosurgery(LMS) and voice therapy for the patients with benign vocal cord lesions. But the difference of voice improvement by onset time of voice therapy has not been reported. The purpose of this study is to analyze the differences of voice improvement by voice analysis test between the two groups with different onset time of voice therapy. Materials and Methods : Two groups, each of which comprises 15 patients, were analyzed. For the one group, the voice therapy was initiated 1 day after LMS. For the other, the therapy was initiated 1 week after LMS. Voice analytic parameters of the two groups were statistically analized to identify difference in voice improvement. Results : All measured parameters improved after voice therapy in two groups and showed no significant difference between two groups. Conclusions : The onset time of voice therapy after LMS has no significant impact on post-operative voice quality in the patients with benign vocal cord lesions. Early onset of post-operative voice therapy may serve as treatment modality for patients with benign vocal cord lesions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.75-80
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• 2021

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly. Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared. Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved. Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient's vocalization and improving voice quality, pitch and loudness.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.1
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• pp.25-31
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• 2017

Background and Objectives : Though voice therapy is proven to be effective in academia, treatment results and satisfaction level are inconsistent in clinics. The inconsistency may rise from diverse vocal cords misuse patterns in patient population as they suffer from different diseases or have bad phonation habits. In order to overcome the limitation, we uniformized patients' vocal cords with injection laryngoplasty prior to voice therapy. The efficacy of voice therapy and consistency in treatment results after injection laryngoplasty were assessed. Materials and Methods : Patients diagnosed with vocal nodules were either treated with injection laryngoplasty followed by voice therapy (combined treatment group) or voice therapy only (voice therapy group). Each group consisted of 15 patients. Acoustic measures (jitter, shimmer, NHR), aerodynamic measures (MPT, Psub, MAFR), and subjective auditory conscious measures (K-VHI, K-VRQOL) between two groups were analyzed. Results : After treatments, both groups improved in terms of acoustic, aerodynamic, and subjective auditory conscious measures compared to pre-treatment. Combined treatment group had statistically significantly greater improvement in shimmer, P in K-VHI, and PF in K-VRQOL compared to voice therapy group. Conclusion : Injection laryngoplasty treatment prior to voice therapy synergizes in treating patients compared to voice therapy only.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.229-234
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• 2018

Background and Objectives : Vocal nodules occur with a 12-22% prevalence in pediatric populations. Most otolaryngologists recommend voice therapy as the primary treatment. The aim of this study is to evaluate patient compliance with voice therapy and its effect on vocal nodules in children. Materials and Methods : We retrospectively reviewed 44 pediatric patients between 3 and 11 years old diagnosed with vocal nodules between March 2015 and December 2017. We evaluated the treatment adoption rate, dropout rate during voice therapy, and reasons for dropout. For patients who completed voice therapy, we measured the changes in nodule size, perceptual parameters, and acoustic parameters. We evaluated patient satisfaction using the pediatric voice handicap index (P-VHI). Results : Of the 44 pediatric patients diagnosed with vocal nodules, 22 (50%) agreed to voice therapy. Of the 22 patients who started voice therapy, 5 (22.7%) dropped out during therapy because they were unsatisfied with their treatment. Another 4 patients discontinued therapy for reasons unrelated to treatment effectiveness. Vocal nodule disappeared or decreased in all 13 patients who completed voice therapy. All voice parameters were improved and statistically significant changes were observed in perceptual, acoustic, and P-VHI parameters. Conclusions : Although compliance to voice therapy among the pediatric patients with vocal nodules was low, there were significant improvements in voice parameters for those who completed voice therapy. A change toward a positive perception of voice therapy is necessary and a multidisciplinary approach is needed to improve the effect of voice therapy on pediatric patients with vocal nodules.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.145-150
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• 2002

Background and Objectives : Patients with so-called 'functional voice disorders' who have structurally normal larynges and demonstrate muscle misuse in the larynx, and those with several interacting causes including habitual muscle tension, are probably better defined as having a 'muscle misuse voice disorder'. The purpose of this study was to analyze the voice and effectiveness of voice therapy in patients with functional voice disorders and to provide a guide for the treatment of functional voice disorder. Materials and Method : The records of 35 patients, presenting with functional voice disorder and receiving voice therapy during October, 2001 to September, 2002, were reviewed. Prior to voice therapy, the stroboscopic examination of their larynx, aerodynamic and acoustic analysis was done. The results of voice therapy were compared according to the patient's subjective, perceptual evaluation of voice, and maximal phonation time. Results : Patient's subjective, perceptual evaluation, and maximal phonation time showed superior results after voice therapy. Conclusion : The result of this study indicates that voice therapy is an effective treatment method of patients with functional voice disorder, especially muscular tension dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.68-75
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• 2005

The treatment of sulcus vocalis and vocal bowing has been commonly used Thyroplasty Type surgery or injection within vocal folds such as Teflon, silicone, collagen. However, and treatment has not been acquired satisfactory treatment effect. This study was conducted to demonstrate voice therapy effect using singer's vocal technique and respiratory training. 4 patients (1 male, 3 females) with sulcus vocalis or bowing, with or without scar were selected for this study and we compared with acoustic, aerodynamic measures and stroboscopy observation before and after voice therapy. The results showed that 1) case 1 (48yr, male) with sulcus vocalis decreased F0 (Fundamental Frequency), increase CQ(Close Quotient) and high degree of satisfaction but not improved voice quality after voice therapy. 2) case 2(19yrs, femal) with mild sulcus vocalis improved as normal voice quality after voice therapy. 3) case 3(38yrs, female) with functional bowing showed abnormalvocal contact before therapy whereas CQ was increased after voice therapy. 4) case 4(27yrs, female) with vocal atrophy and vocal bowing changed normal range of Fo and increased CQ after voice therapy. Even though contact area of both vocal folds was increased and lowered F0 after voice therapy, current outcomes revealed that normal voice quality was not regained. These results might signify that it was difficult that vocal folds couldn't be recovery of symmetry and viscoelastic property of mucosal wave through voice therapy. However, it was difficult for this study to maintain voice therapy so that evaluate effect of voice therapy for long-term. Further study will be needed to long-term follow-up for voice therapy with these patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.2
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• pp.145-151
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• 2001

Background and Objectives : A voice therapy can be used the basic method for the voice improvement of patients with the voice disorders. However, according to each voice disorders, various results of treatments have been reported. The purpose of this study was to evaluate the clinical features of the patients who did not improved after the voice therapy and to explore factors that could affect the results of the voice therapy. Material and Method : There are patients (n=49) diagnosed as the vocal nodule and patients (n=13) diagnosed as the vocal polyp. They received the voice therapy more than 6 times from September, 2000 to August, 2001. Clinical features, stroboscopic findings, esophagographic findings and PNS x-ray findings were compared between the improved and the nonimproved groups. Results : Before the voice therapy, PNS x-ray found two of all patients had the paranasal sinusitis. 14 of the vocal nodule patients (28.6%) and 8 of the vocal polyp (61.5%) had GERD in the esophagogram. However, the recovery rate after the voice therapy had no significant difference in both the vocal nodule and vocal polyp with GERD. In patients with the vocal nodule, 47 of 49 (95.9%) improved after the voice therapy. 6 of them were found the clearly decreased lesion in the stroboscopy. But, in patients with the vocal polyp, 7 of 13 (53.8%) improved after the voice therapy and did not have improvement through the stroboscopy. Conclusion : If the treatment of GERD is given with the voice therapy after the evaluation of GERD, it is helpful to increase the effects of the voice therapy. And, if patients were improved partially or unimproved after voice therapy, it was important to evaluate all factors-motivation, compliance and cooperation-related with patients will. Through this, some factors might be minimized except diseases differences.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.35-39
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• 2016

Background and Objectives : Voice therapy is proven to be effective, but patients are reluctant to receive the therapy when physicians recommend it. This phenomenon may due to patients'lack of trust in or low satisfaction level of the therapy. This study aimed to evaluate patients'satisfaction level after voice therapy and identify factors that could increase the satisfaction. Materials and Methods : First, the fraction of patients who were recommended voice therapy ahead and completed it was studied, and survey was conducted on those who finished ten voice therapy sessions. The patients'1) satisfaction level during the therapy, 2) satisfaction level about physician's explanation about the therapy, 3) willingness to recommend, 4) satisfaction level about the results were assessed, and was correlated with overall satisfaction level. In each category, patients' gender-, age-, and disease type-related differences were analyzed. Results : Patients under 19 years old were most satisfied during the voice therapy; patients above 40 years old showed statistically significantly higher satisfaction level regarding satisfaction with physician explanation about treatments and with treatment results compared to other ages groups. Patients above 40 also showed the highest willingness to recommend. 26.5% of patients either refused to or discontinued voice therapy. 84.3% were satisfied with treatment results. Considering variabilities among factors, patients'satisfaction with physician explanation about treatment and willingness to recommend had positive correlation. Conclusion : Though 26.3% of patients received voice therapy when physicians recommended, patients who completed the therapy were overall satisfied.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.1
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• pp.45-49
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• 2022

Post-thyroidectomy syndrome refers to various voice changes experienced after the thyroid surgery. Among them, surgery or injection therapy has been prioritized over voice therapy for the bilateral vocal cord paralysis. However, if it is possible to determine whether voice therapy can be applied first, a faster treatment recovery will be possible. In this study, voice therapy was performed on a 59-year-old female patient with bilateral vocal cord paralysis after total thyroidectomy. This study is to presents the criteria for applying the voice therapy first for bilateral vocal folds paralysis and to share successful voice therapy sessions.