Phonetics and Speech Sciences (말소리와 음성과학)

Korean Society of Speech Sciences (한국음성학회)
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Comparison of mean airflow rate before and after treatment in patients with sulcus vocalis according to aerodynamic analysis methods

성대구증 환자의 공기역학적 검사 방법에 따른 치료 전과 후의 평균호기류율 비교

  • Seung Yeon Lee (Department of Otorhinolaryngology, Yongin Severance Hospital, Yonsei University) ;
  • Hong-Shik Choi (Jeil ENT) ;
  • Jaeock Kim (Major in Speech Pathology Education, Graduate School of Education, Kangnam University)
  • 이승연 (연세대학교 용인세브란스병원 이비인후과) ;
  • 최홍식 (제일이비인후과) ;
  • 김재옥 (강남대학교 교육대학원 언어치료교육전공)
  • Received : 2023.11.17
  • Accepted : 2023.12.11
  • Published : 2023.12.31
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Abstract

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).

성대구증은 불완전 성대폐쇄부전으로 평균호기류율(mean airflow rate, MFR)이 높은 것이 특징이다. MFR은 phonatory aerodynamic system(PAS)의 두 공기역학적 검사 방법(MXPH, VOEF)으로 측정하며, 두 검사 방법에 따라 결과가 다르게 나타날 수 있다. 본 연구는 성대구증 환자 30명을 대상으로 PAS의 MXPH, VOEF 프로토콜에 따른 MFR의 치료 전과 후 차이, 치료 전후 변화량 간의 차이가 있는지 비교하였다. 그리고 치료 전과 후의 Voice handicap index(VHI), GRBS 및 기본주파수(F0)를 비교하였다. 연구결과, 성대구증 환자의 치료 전과 후 모두에서 검사 방법 간에 유의한 차이가 나타났으나 치료 전후의 변화량은 유의한 차이가 없었다. VHI와 GRBS는 치료 전에 비해 치료 후에 유의하게 감소하였으나 F0는 치료 전과 후에 유의한 차이가 없었다. 본 연구를 통해 성대구증 환자의 치료에 따른 MFR 변화를 평가할 때, 두 공기역학적 검사 방법(MXPH, VOEF) 중 어떠한 검사 방법을 사용해도 된다는 것을 알 수 있다.

Keywords

References

  1. Cho, J. H. (2021). Clinical applications of office-based laryngeal surgery with KTP laser. Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics, 32(3), 118-123. https://doi.org/10.22469/jkslp.2021.32.3.118
  2. Choi, J. N., Kim, H., Nam, C. M., & Choi, H. S. (2007). Characteristics of glottal area waveform and phonation in patients with unilateral vocal fold palsy or sulcus vocalis. Korean Journal of Communication Disorders, 12(3), 487-507.
  3. Chun, E., Shon, Y. H., Baek, S. J., Lee, P. H., Nam, C. M., Lee, J. E., & Choi, Y. (2010). Characteristics of respiration and phonation in patients with young-onset Parkinson's disease compared to normal adults. Korean Journal of Communication Disorders, 15(4), 537-548.
  4. Dailey, S. H., & Ford, C. N. (2006). Surgical management of sulcus vocalis and vocal fold scarring. Otolaryngologic Clinics of North America, 39(1), 23-42. https://doi.org/10.1016/j.otc.2005.10.012
  5. Ford, C. N., Inagi, K., Khidr, A., Bless, D. M., & Gilchrist, K. W. (1996). Sulcus vocalis: A rational analytical approach to diagnosis and management. Annals of Otology, Rhinology & Laryngology, 105(3), 189-200. https://doi.org/10.1177/000348949610500304
  6. Gerratt, B. R., Kreiman, J., & Garellek, M. (2016). Comparing measures of voice quality from sustained phonation and continuous speech. Journal of Speech, Language, and Hearing Research, 59(5), 994-1001. https://doi.org/10.1044/2016_JSLHR-S-15-0307
  7. Hammarberg, B., Fritzell, B., Gaufin, J., Sundberg, J., & Wedin, L. (1980). Perceptual and acoustic correlates of abnormal voice qualities. Acta Oto-Laryngologica, 90(1-6), 441-451. https://doi.org/10.3109/00016488009131746
  8. Han, K. Y., & Nam, S. Y. (2000). Voice and videostroboscopic analysis of sulcus vocalis after slicing mucosa surgical technique. Korean Journal of Otorhinolaryngology-Head and Neck Surgery, 43(11), 1227-1231.
  9. Hapner, E. R., & Klein, A. (2009). A synopsis of the management of vocal fold scar. Perspectives on Voice and Voice Disorders, 19(1), 15-23. https://doi.org/10.1044/vvd19.1.15
  10. Hirano, M. (1981). Psycho-acoustic evaluation of voice. In Clinical examination of voice (pp. 81-84). Wien, Austria; Springer-Verlag.
  11. Hirano, M., Yoshida, T., Tanaka, S., & Hibi, S. (1990). Sulcus vocalis: Functional aspects. Annals of Otology, Rhinology & Laryngology, 99(9), 679-683. https://doi.org/10.1177/000348949009900901
  12. Hsiung, M. W., Kang, B. H., Su, W. F., Pai, L., & Lin, Y. H. (2004). Combination of fascia transplantation and fat injection into the vocal fold for sulcus vocalis: Long-term results. Annals of Otology, Rhinology & Laryngology, 113(5), 359-366. https://doi.org/10.1177/000348940411300504
  13. Hwang, C. S., Lee, H. J., Ha, J. G., Cho, C. I., Kim, N. H., Hong, H. J., & Choi, H. S. (2013). Use of pulsed dye laser in the treatment of sulcus vocalis. Otolaryngology-Head and Neck Surgery, 148(5), 804-809. https://doi.org/10.1177/0194599813479909
  14. Jacobson, B. H., Johnson, A., Grywalski, C., Silbergleit, A., Jacobson, G., Benninger, M. S., & Newman, C. W. (1997). The voice handicap index (VHI): Development and validation. American Journal of Speech-Language Pathology, 6(3), 66-70. https://doi.org/10.1044/1058-0360.0603.66
  15. Jeong, J. K. (2020). A comparison of aerodynamic characteristics in muscle tension dysphonia and adduction spasmodic dysphonia using KayPENTAX Phonatory Aerodynamic System Model 6600(Master's thesis). Myungji University, Seoul, Korea.
  16. Jiang, J., Chen, H. J., Stern, J., & Solomon, N. P. (2004). Vocal efficiency measurements in subjects with vocal polyps and nodules: A preliminary report. Annals of Otology, Rhinology & Laryngology, 113(4), 277-282. https://doi.org/10.1177/000348940411300404
  17. Jung, C. M., Kim, J., Lim, J. Y., & Choi, H. S. (2017). Surgical treatment of sulcus vocalis using KTP laser. Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics, 28(2), 131-134. https://doi.org/10.22469/jkslp.2017.28.2.131
  18. Kang, Y. A., Chang, J. W., & Koo, B. S. (2016). Aerodynamic features in patients with vocal polyps before & after laryngomicrosurgery. Phonetics and Speech Sciences, 8(3), 39-49. https://doi.org/10.13064/KSSS.2016.8.3.039
  19. Kang, Y. A., Chang, J. W., & Koo, B. S. (2017). Relationship between voice fatigue and voice assessment in patients with voice disorders and applicability of voice fatigue index in Korean version. Korean Journal of Otorhinolaryngology-Head and Neck Surgery, 60(5), 232-242. https://doi.org/10.3342/kjorl-hns.2016.17552
  20. Kang, Y. A., Yoon, K. C., & Kim, J. O. (2012). An aerodynamic and acoustic analysis of the breathy voice of thyroidectomy patients. Phonetics and Speech Sciences, 4(2), 95-104. https://doi.org/10.13064/KSSS.2012.4.2.095
  21. Kim, J. (2013). Aerodynamic characteristics, vocal efficiency, and closed quotient differences according to fundamental frequency fixation. Phonetics and Speech Sciences, 5(1), 19-26. https://doi.org/10.13064/KSSS.2013.5.1.019
  22. Kim, J. H., & Choi, H. S. (2016). The principle and clinical application of pulsed dye laser in laryngology. Journal of Clinical Otolaryngology Head and Neck Surgery, 27(2), 224-230. https://doi.org/10.35420/jcohns.2016.27.2.224
  23. Kim, M. S., Pyo, H. Y., Choi, H. S., Kim, Y. H., & Kim, K. M. (1997). Clinical analysis of persistent and recurrent postoperative dysphonia. Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics, 8(2), 225-231.
  24. Korean Society of Laryngology, Phoniatrics and Logopedics. (2016). Laryngophonetics: Understanding phonation and voice therapy. Seoul: Punmun Education Press.
  25. Kwon, T. K., & Lim, Y. S. (2008). Aerodynamic analysis of phonation. Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics. 19(2), 85-88.
  26. Lee, S., Lim, S., Lim, J., & Choi, H. (2018). A comparison among repeated measures of the voicing efficiency protocol in the aerodynamic assessment. Communication Sciences & Disorders, 23(3), 755-763. https://doi.org/10.12963/csd.18516
  27. Lim, J. Y. (2006). Clinical use of voice analysis and electroglottographic measurement in sulcus deformity of vocal folds (Master's thesis). Yonsei University, Seoul, Korea.
  28. Lim, J. Y., Kim, J., Choi, S. H., Kim, K., Kim, Y. H., Kim, H. S., & Choi, H. S. (2009). Sulcus configurations of vocal folds during phonation. Acta Oto-laryngologica, 129(10), 1127-1135. https://doi.org/10.1080/00016480802579058
  29. Murry, T., Xu, J. J., & Woodson, G. E. (1998). Glottal configuration associated with fundamental frequency and vocal register. Journal of Voice, 12(1), 44-49. https://doi.org/10.1016/S0892-1997(98)80074-X
  30. Neuenschwander, M. C., Sataloff, R. T., Abaza, M. M., Hawkshaw, M. J., Reiter, D., & Spiegel, J. R. (2001). Management of vocal fold scar with autologous fat implantation: Perceptual results. Journal of Voice, 15(2), 295-304. https://doi.org/10.1016/S0892-1997(01)00031-5
  31. Park, S. Y., Kim, J. O., Lim, S. E., Nam, D. H., & Choi, H. S. (2008). The perceptual evaluation and aerodynamic analysis of spasmodic dysphonia. Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics, 19(1), 38-42.
  32. Pontes, P., & Behlau, M. (1993). Treatment of sulcus vocalis: Auditory perceptual and acoustical analysis of the slicing mucosa surgical technique. Journal of Voice, 7(4), 365-376. https://doi.org/10.1016/S0892-1997(05)80260-7
  33. Pyo, H. Y. (2019). A study on the aerodynamic characteristics of sustained vowel and continuous speech production of female voice disorder patients. Communication Sciences & Disorders, 24(2), 518-524. https://doi.org/10.12963/csd.19600
  34. Rosen, C. A. (2000). Vocal Fold Scar: Evaluation and treatment. Otolaryngologic Clinics of North America, 33(5), 1081-1086. https://doi.org/10.1016/S0030-6665(05)70266-8
  35. Watanabe, H., Shin, T., Matsuo, H., Okuno, F., & Tsuji, T. (1994). Studies on vocal fold injection and changes in pitch associated with alcohol intake. Journal of Voice, 8(4), 340-346. https://doi.org/10.1016/S0892-1997(05)80282-6
  36. Yang, H. C., Jeong, B. S., Kim, D. Y., & Woo, J. H. (2012). Voice analysis and treatment result according to configuration of sulcus vocalis. Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics, 23(2), 119-123.
  37. Zhang, F., Sprecher, A. J., Wei, C., & Jiang, J. J. (2010). Implantation of gelatin sponge combined with injection of autologous fat for sulcus vocalis. Otolaryngology-Head and Neck Surgery, 143(2), 198-203. https://doi.org/10.1016/j.otohns.2010.03.002
  38. Zraick, R. I., Smith-Olinde, L., & Shotts, L. L. (2012). Adult normative data for the KayPENTAX phonatory aerodynamic system model 6600. Journal of Voice, 26(2), 164-176. https://doi.org/10.1016/j.jvoice.2011.01.006