• Phonetics and Speech Sciences
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• v.7 no.4
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• pp.93-99
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• 2015

In case of PAS test, the air is sometimes leaked although the mask is tightly attached to the face, which is not reliable on the measured values. Therefore, this study aimed to assist the clinical practice suggesting the test method of PAS without air leakage. In the healthy subjects with 12 males and 12 females over 19 years old, three types of tests were performed on the voicing efficiency among the protocol of PAS Model 6600. They are; first, to attach the mask tightly to the face holding the handle of PAS with the subject's two hands (Method 1); second, to attach the mask tightly to the face holding the handle of PAS with the subject's one hand and pushing the body of PAS strongly with the other hand (Method 2); and third, to attach the mask tightly to the face pushing the upper part of the mask by the tester when the subject attached the mask to his or her face holding the handle of PAS with two hands (Method 3). Upon the study analyses, the mean negative pressure, the mean phonogram, subglottic air pressure, and voicing efficiency were shown to be statistically significantly different during PAS test in males depending on the methods. (p<.05) In case of females, only the target airflow rate showed significant difference depending on the methods during PAS test. (p<.001) In conclusion, Method 2 enhanced the noise level and strength while Method 1 was likely to leak the air more compared to the other two methods in males. In case of females, Method 1 showed significant leakage of the air flow. Not to allow the air flow leakage without affecting the outcome of PAS test, it will be the most useful for the tester to push the mask to the subject's face tightly (Method 3).

• Phonetics and Speech Sciences
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• v.4 no.2
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• pp.95-104
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• 2012

Thyroidectomy patients may have vocal paralysis or paresis, resulting in a breathy voice. The aim of this study was to investigate the aerodynamic and acoustic characteristics of a breathy voice in thyroidectomy patients. Thirty-five subjects who have vocal paralysis after thyroidectomy participated in this study. According to perceptual judgements by three speech pathologists and one phonetic scholar, subjects were divided into two groups: breathy voice group (n = 21) and non-breathy voice group (n = 14). Aerodynamic analysis was conducted by three tasks (Voicing Efficiency, Maximum Sustained Phonation, Vital Capacity) and acoustic analysis was measured during Maximum Sustained Phonation task. The breathy voice group had significantly higher subglottal pressure and more pathological voice characteristics than the non breathy voice group. Showing 94.1% classification accuracy in result logistic regression of aerodynamic analysis, the predictor parameters for breathiness were maximum sound pressure level, sound pressure level range, phonation time of Maximum Sustained Phonation task and Pitch range, peak air pressure, and mean peak air pressure of Voicing Efficiency task. Classification accuracy of acoustic logistic regression was 88.6%, and five frequency perturbation parameters were shown as predictors. Vocal paralysis creates air turbulence at the glottis. It fluctuates frequency-related parameters and increases aspiration in high frequency areas. These changes determine perceptual breathiness.

• Phonetics and Speech Sciences
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• v.6 no.4
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• pp.195-203
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• 2014

The aim of this study was to investigate the effects of phonation types ([+/- aspirated], [+/- fortis]) on aerodynamic measures with Korean bilabial stops. Sixty-three healthy young adults (30 males, 33 females) participated to evaluate the VOEF (Voicing Efficiency) tasks with bilabial stop consonants /$p^h$/, /p/, /p'/ using Phonatory Aerodynamic System (PAS) Model 6600 (Kay PENTAX Corp, Lincoln Park, NJ). All VOEF measures were significantly influenced by phonation types except RANP(pitch range)(p <.01). For sound pressure, maximum SPL, mean SPL, and Mean SPL during Voicing have been shown to be significantly greatest in fortis stop /p'/ than aspirated /$p^h$/ and lenis stop /p/ (p<.001). On the other hand, mean pitch after lenis stop was significantly lower than after aspirated and fortis stops (p<.001). Peak expiratory airflow, Target airflow, and FVC (Expiratory volume) were significantly lowest in fortis stop /p'/ which might be associated with higher aerodynamic resistance while peak air pressure and mean peak air pressure during closure were significantly lower in lenis stop /p/. Additionally, AEFF (Aerodynamic efficiency) was significantly higher in fortis stop /p'/ than lenis stop /p/ as well as aspirated stop /$p^h$/ (p<.001). Thus, sound pressure, airflow parameters, and aerodynamic resistance made crucial roles in distinguishing fortis /p'/ from lenis stop /p/ and aspirated. Additionally, pitch and subglottal air pressure parameters were important aerodynamic characteristics in distinguishing lenis /p/ from fortis /p'/ and aspirated /$p^h$/. Therefore, accurate aspirated /p/ stop consonant should be elicited when collecting the airflow, intraoral pressure related data with patients with voice disorders in order to enhance the reliability and relevance or validity of aerodynamic measures using PAS.

• Phonetics and Speech Sciences
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• v.6 no.1
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• pp.105-117
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• 2014

The purpose of this study was to (1) establish a Korean adult normative database for phonatory aerodynamic measures obtained with the KayPENTAX Phonatory Aerodynamic System (PAS) Model 6600, (2) investigate the intra-subject reliability of these measures across three testing sessions, and (3) examine the effect of gender on those measures. 170 healthy normal speakers (70 men and 100 women) between the ages 18 and 49 years participated in the study. The PAS protocol of maximum phonation and voicing efficiency were conducted and 25 measures were obtained. All aerodynamic measures taken in this study demonstrated high intra-subject reliability in clinical aspect. There were no significant effect of gender in the measures related to sound pressure and subglottal pressure. However, significant differences for gender were found for phonation time, airflow rate, expiratory volume, aerodynamic power, SPL range, pitch range, mean pitch, aerodynamic resistance, and aerodynamic efficiency. Clinicians should be aware of significant gender effects in some aerodynamic parameters when interpreting the data obtained from PAS.

• Phonetics and Speech Sciences
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• v.8 no.3
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• pp.39-49
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• 2016

The present study examined the change of aerodynamic features after laryngomicrosurgery in patients with vocal polyps. Aerodynamic evaluation was performed in thirty-nine patients (15 males and 24 females) one week before surgery and four weeks after surgery. Evaluation protocols of vital capacity, maximum sustained phonation(MXPH), and voicing efficiency(VOFT) were used to collect 29 phonatory aerodynamic measures, requiring voice with a comfortable pitch and loudness. Statistically significant changes were found for phonation time and airflow values in the MXPH protocol, while changes were also found for airflow values, subglottal pressure values and acoustic resistance values in the VOFT protocol. Although phonation time was increased in both male and female patients, gender-dependent changes were found in airflow measurements. Men's phonation time increased with no difference in airflow rate, but women's phonation time increased with decreased airflow rate and lower subglottal pressure. The changes of aerodynamic features may be affected by women's self-perceived change for vocal attitude, which was reducing sense of vocal effort after surgery.

• 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.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.

• The Journal of the Korean dental association
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• v.48 no.1
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• pp.6-11
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• 2010

Amid the rapid transitions in both local and international markets, the Korean dental industry is facing more challenges than at any time in its history. This paper tried to address some of the key issues faced by the industry as well as the policy issues and I direction of implementation that the Korean Dental Association (KDA) is expected to tackle. First, the direction of reforming the country's health insurance system was examined with emphasis on the expected changes in and improvement of the fee-for-service reimbursement system (FFSRS) and medical reimbursement system (MRS). With FFSRS, the most urgent issue would be ameliorating the current lop-sided, unreasonable reimbursement system that prevents suppliers from voicing their opinions. To help achieve that goal, the limited authority and responsibility of the president of National Health Insurance Corporation (NHIC) as one of the contract-making parties must be clarified. In addition, the functions of NHIC's Health Insurance Finance Committee must be restricted; at the same time, the panel organization of the Health Insurance Policy Review Committee needs to be reformed to embrace greater democracy. As with MRS, the government is considering a block budget bill to help promote efficiency in employing and managing the health insurance fund. Policymakers must understand that the implementation of such proposal could exacerbate an already dire situation. Improving MRS requires meeting the following preconditions: (a) the structurally vicious cycle of small charge-small salary needs to be resolved, and a certain percentage of fee raise must be guaranteed on a yearly basis to help adjust the fee system to a more realistic level; (b) the supply-and-demand balance in producing health care professionals must be improved including the prevention of oversupply of doctors, nurses, etc., and; (c) institutional strategies must be provided to enhance the quality of medical care and ensure academic advancement in health care disciplines.

• Phonetics and Speech Sciences
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• v.15 no.4
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• pp.61-69
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• 2023

Sulcus vocalis is characterized by incomplete closure of the vocal folds, with a high mean airflow rate (MFR) as a distinctive feature. The MFR is measured using two aerodynamic analysis methods [the maximum sustained phonation protocol (MXPH) and voicing efficiency protocol (VOEF)] of the phonatory aerodynamic system (PAS), and the results may vary depending on the method. This study compared the differences in MFR before and after treatment (microsurgery and voice therapy) according to the MXPH and VOEF of the PAS in 30 patients with sulcus vocalis. Additionally, we examined whether there were differences in the subjective voice evaluation (voice handicap index, VHI), perceptual voice evaluation (GRBS), and fundamental frequency (F0) before and after treatment. The results showed significant differences between the two methods, both before and after treatment, in patients with sulcus vocalis. However, there were no significant differences by methods in the changes before and after treatment. The VHI and GRBS scores significantly decreased after treatment; however, F0 showed no significant differences before and after treatment. This study indicates that when evaluating MFR changes in patients with sulcus vocalis, it is acceptable to use either aerodynamic analysis (MXPH or VOEF).