• Proceedings of the KSLP Conference
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• 2002.04a
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• pp.75-82
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• 2002

Botulinum toxin-A, a neurotoxin derived from Clostridia Botulinum, has been injected into the laryngeal muscle(s) for the treatment of the spasmodic dysphonia at the Voice Clinic, Yonsei Institute of Logopedics and phoniatrics since December 1995. We analyzed 355 patients with spasmodic dysphonia, using Botox register review. In the 355 patients, female is 86.8%. male is 13.2%. 305 patients (85.9%) had adductor type of spasmodic dysphonia and 35 patients (9.9%) were vocal tremor type and 15 patients were abduction and mixed type. Botulinum toxin type-A (Botox) injection using EMG was most frequently conducted as 587 cases, comparing with flexible nasopharyngoscopy gudied injection (68cases) and tele- laryn-goscopy guided injection (31cases). In the respect of frequency of Botox injection, 137 patients(38.6%) were injected one time but 1 patient was injected 17times. The mean dose of Botox is 6.2U. Clinically, initial dose of Botulinum toxin-A was high dose (7-8U) but current dose is small dose (3U). And the mean duration of Botox injection is 6.4 month. In conclusion, to optimize effect of the treatment for spasmodic dysphonia, Botulinum toxin-A injection is combined with voice therapy.

• Phonetics and Speech Sciences
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• v.6 no.4
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• pp.189-194
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• 2014

Objective: This study aims to investigate the speech rate, the length of a pause, habitual pitch, and voice intensity of motherese. Subjects and Methods: The research participants comprised 20 mothers (mean age 33 years). Speech data were collected and analyzed using the Real-time Pitch software (KayPENTAX(R)). Results: The average speech rate was 5.33 syllables per second without their infant present and 4.26 syllables per second with their infant present. The average pause length was 1.09 s without their infant present and 1.56 s with their infant present. The average habitual pitch was 199.79 Hz without their infant present and 227.15 Hz with their infant present. The average voice loudness was 61.09 dB without their infant present and 64.49 dB with their infant present. Conclusion: This study presented clinical information for efficiently managing the speech therapy issues of infants and children. This includes proper acoustic and phonological information to recommend to main caregivers.

• Phonetics and Speech Sciences
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• v.9 no.4
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• pp.107-114
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• 2017

The purpose of the current study was to compare selected acoustic and electroglottographic measures (closed quotient, pitch, and loudness) among vowel phonation, traditional voiced lip trill ($VLT_T$), modified voiced lip trill methods ($VLT_M$). A total of 21 participants without voice complaints produced 4-second long samples using each phonation method. Results indicated that mean closed quotient of $VLT_M$ was higher than that of vowel phonation and $VLT_T$, while its range and standard deviation measures were higher than those of vowel phonation. Mean, range, standard deviation, maximum of pitch measures of $VLT_M$ were higher than those of vowel phonation. Lastly, mean and maximum loudness of the $VLT_M$ were higher than $VLT_T$. In conclusion, the current data indicate the possibility to use the $VLT_M$ as a training method for singing or a strategy to facilitate generalization effect of voice therapy. Current results also reflect the necessity for further study pertaining to the long-term effect of the $VLT_M$ training method. Clinical implications are discussed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.17-21
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• 1998

Benign vocal fold lesions such as polyps, nodules and edema are known to be caused by vocal trauma such as voice misuse and/or abuse. Even though these lesions are known to be caused by the same etiology, phonotrauma, they show widely different clinical features and different responses to voice therapy. Previous studies suggested that benign vocal fold lesions represent disturbance in the balance of the extracellular matrix(ECM) constituents of the vocal folds. Collagen is one of the major constituents of ECM. Among collagens, fibrillar collagens are most important ones for maintaining the structural integrity. On the basis of gross morphology, vocal polyps wert divided into angiomatous one and edematous one, and nodules were divided into conical one and sessile one. In these four groups, the pattern of distribution of various fibrillar collagens(type 1, 2, 3, 5) was studied by immunohistochemical staining using paraffin embedded tissues. Within each group, differences among collagen subtypes were insignificant. In edematous polyp, collagens were sparsely dispersed in lamina propria by diffuse edema. In angiomatous polyp, collagens were displaced into submucosal layer by hemorrhagic space. In nodules, collagens were stained compactly in lamina propria. Quite different distributions of fibrillar collagens between polyps and nodules are thought to suggest that vocal polyps and nodules are totally different disorders in their pathophysiology.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.1-6
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• 2020

In unilateral vocal fold paralysis (UVFP) patients, we try to improve their symptoms such as hoarseness or aspiration by restoring nerve functions or medialization laryngoplasty (ML), etc. Until now, ML (thyroplasty and/or arytenoid adduction) is considered as gold standard of treatment for UVFP. However, if recurrent laryngeal nerve (RLN) is damaged and use of RLN is feasible during operation, laryngeal reinnervation (LR) would be a good option. Anastomosis with ansa cervicalis to RLN is most common reinnervation method. Delayed LR may be considered in young patients when the RLN denervation period is not long (less than 2 years) for the treatment of surgery-related UVFP. Injection laryngoplasty and laryngeal framework surgery showed great voice outcomes in UVFP. Combination therapy (neuromuscular pedicle innervation with ML) also showed good post-operative voice outcomes even in longer periods (over 2 years). In pediatric patients, LR would be considered as a good treatment option because all procedures need to general anesthesia.

• International Journal of Computer Science & Network Security
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• v.23 no.4
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• pp.15-24
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• 2023

One of the objectives and aspirations of scientists and engineers ever since the development of computers has been to interact naturally with machines. Hence features of artificial intelligence (AI) like natural language processing and natural language generation were developed. The field of AI that is thought to be expanding the fastest is interactive conversational systems. Numerous businesses have created various Virtual Personal Assistants (VPAs) using these technologies, including Apple's Siri, Amazon's Alexa, and Google Assistant, among others. Even though many chatbots have been introduced through the years to diagnose or treat psychological disorders, we are yet to have a user-friendly chatbot available. A smart generative cognitive behavioral therapy with spoken dialogue systems support was then developed using a model Persona Perception (P2) bot with Generative Pre-trained Transformer-2 (GPT-2). The model was then implemented using modern technologies in VPAs like voice recognition, Natural Language Understanding (NLU), and text-to-speech. This system is a magnificent device to help with voice-based systems because it can have therapeutic discussions with the users utilizing text and vocal interactive user experience.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.124-127
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• 2019

Vocal fold scarring is an intractable phonosurgical condition. The number of patients with vocal fold scars is increasing with the aging of society and with the increasing application of laryngeal microsurgery. Many methods are available to treat these, including voice therapy, stem cells, regenerative scaffolds, and growth factors. However, no standard treatment strategy has yet been established, and novel techniques are required. Basic fibroblast growth factor has been shown to be effective for the treatment of mild chronic vocal fold scarring. The combined use of basic fibroblast growth factor and regenerative scaffolds is currently under investigation. Here, we report a female patient in whom vocal fold scarring developed after two laryngeal microsurgeries. We performed laryngeal microsurgery to remove the scar tissue and used basic fibroblast growth factor and a collagen scaffold to promote healing. The patient's voice quality was greatly increased, and she was content with her voice after 2 years of follow-up. This is the first report of this methodology in Korea and is presented along with a review of the literature.

• Phonetics and Speech Sciences
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• v.4 no.1
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• pp.125-131
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• 2012

The patients with incomplete glottic closure have an important feature decreasing the maximum phonation time (MPT) because airflow rate or air leakage is greater than people without voice disorders. Also they can appear a problem in the intensity regulation. This study analyzed MPT difference based on the comfortable intensity and louder intensity and the correlation between MPT and respiration volume of unilateral vocal fold palsy (UVFP) and sulcus vocalis (SV) group. The twenty with UVFP, the 21 with SV, the 21 normal subjects measured MPT in /a/ vowel prolongation task with comfortable intensity and louder intensity and compared analysis by measuring FVC, $FEV_1$, $FEV_1/FVC$ to analyze the correlation between MPT and respiration volume. First, a comparison of MPT according to the intensity between groups is that MPT of the normal group was statistically significant long compared to the patient group in comfortable intensity, but MPT between groups was not statistically significant difference in the louder intensity. Second, an analysis of the correlation between MPT and respiration volume is that this was statistically significant correlation between MPT in comfortable intensity and MPT in louder intensity. But this did not show statistically significant correlation between intensity and respiration volume. This study can be supported the preceding study results deduced that shorting MPT of the patient group compared to the normal group was originated in the problem of laryngeal valving mechanism at the level of vocal folds rather than a problem of respiratory function. Also at the phonation by varying the intensity, the result can deduce that in the case of patient group, the length of MPT had been improved by increasing the glottal closure ratio in the louder intensity. These results can support the theoretical basis that should be applied to the clinicians by varying the intensity at the voice evaluation and voice therapy for the patients with the glottis incompetence.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.96-99
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• 2017

Background and Objectives : The management of Reinke's edema includes usually medical treatment and voice therapy. Laryngomicrosurgery (LMS) is also necessary, especially to improve airway obstruction. However, voice outcome after LMS has not been determined well. The aim of this study was to evaluate effectiveness of LMS for Reinke's edema and analyze the voice outcomes after LMS. Materials and Methods : Twenty-five patients with Reinke's edema who underwent LMS from September 2007 to December 2016 were enrolled in this study. We analyzed reflux finding score (RFS), reflux symptom index (RSI), and acoustic parameters before and after surgery. Results : Male was 15 (60%) and female was 10 (40%), and mean age was 49.6 years. Preoperative mean value of RFS decreased significantly up to 3 months after LMS ($18.3{\pm}2.2$ and $10.0{\pm}2.2$ at preoperative and 3 months postoperatively, respectively). The mean value of Jitter decreased significantly before and after surgery ($2.71{\pm}2.81%$ and $1.06{\pm}1.21%$ before and after LMS, p=0.041). The mean value of Shimmer also decreased significantly before and after surgery ($7.97{\pm}3.63%$ and $4.83{\pm}1.85%$, respectively, p=0.006). Conclusion : LMS is effective in the treatment of Reinke's edema. It results in favorable acoustic outcomes and laryngoscopic findings in properly selected patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.166-172
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• 1997

Background : For example, aerodynamic study, vibratory study, acoustic study, neuro-muscular test and psychoacoustic evaluation, a number of objective methods are now available for assessing pathologic voice change. They help to differentiate pathologic condition from normal condition and to monitor pathologic and aging change. These laboratory analyses are used commonly to monitor speech therapy and to follow a patient's recovery after surgery. Objectives : We investigated the values of jitter, shimmer and NNE of normal person and hoarseness patients in Korea. The values of Jitter and shimmer might be meaningful parameters distinguishing pathologic vibration from normal and recovery after surgery. Materials and Methods : Statistical significance between normal control and 48 subjects taken microlaryngeal surgery were compared with Dr. speech science program that is computerized system for acoustic analysis of voice production employed to determine vocal characteristics of pitch perturbation(jitter) and amplitude perturbation(shimmer). Results : The mean normal values of jitter and shimmer were 0.226${\pm}$0.110(%), 2.200${\pm}$0.421(%) in male and 0.164${\pm}$0.060(%), 2.063 ${\pm}$0.575(%) in female. In patients with vocal nodule, the preoperative and postoperative values of jitter and shimmer were valueless. In patients with vocal polyps, the preoperative and postoperative values of jitter and shimmer were valuable. Conclusion : Dr. speech science program was effective to monitor laryngeal disease and aging changes.