비디오스트로보스코피를 이용한 성대주기(glottal cycle)의 관찰은 질환의 감별 및 치료 전후의 결과를 비교하는데 중요한 정보를 제공하지만, 관찰자의 주관적 견해나 판단능력에 따라 결과의 판독에 많은 영향을 미칠 수 있다. 이에 비디오스트로보스코피 소견의 객관화를 위한 시도가 최근 보고되고 있으나 아직은 그 성과나 결과 등이 참고치로 활용하기에는 부족한 실정이다. 이에 저자들은 정상 성인을 대상으로 발성시의 주파수와 강도의 변화에 따른 glottal cycle의 변화를 정량화 함으로써 추후 연구나 임상적용 등의 기본자료로서 활용하고자 하였다. 정상성인 남녀 각 5명을 대상으로 평상시 대화수준, 고음, 큰 소리의 세 가지 조건에서, 지속적인 /이/ 발성을 후두비디오스트로보스코프를 이용하여 녹화한 뒤, image analysis 프로그램(KSIP, Kay Elemetrics Corp., NJ, USA)을 이용하여 glottal area waveform(GAW)과 amplitude/symmetry waveform(A/SW)을 구하였다. 네 개의 연속적인 glottal cycle의 GAW를 이용하여 peak glottal area, opening ＆ closing phase, open quotient, speed quotient, baseline offset 등의 평균값을 각각의 조건에서 비교하여 보았으며, A/SW를 이용하여 성대의 종축을 기준으로 3등분한 뒤 전, 후, 중간 부위에서 성대운동의 진폭과 그 움직임의 양상을 서로 비교하여 보았다. 발성의 조건에 따라 성대주기와 성대운동의 진폭과 그 양상이 달라짐을 객관적으로 판단할 수 있었으나, 이를 참고치나 기준치로 활용하기 위하여는 더 많은 수의 피검자를 대상으로, 발성의 조건을 체계적으로 변화시킨 연구가 뒷받침되어야 하리라고 사료되었다.

Measuring phonatory stability using MDVP(Multi-dimensional voice program, Kay Elemetrics Corp., NJ, USA) are becoming popular in many Korean clinics and laboratories, yet questions about standardization and reference values have remained. The purpose of present study was to examine the effects of frequency and intensity variation on the results of acoustic analysis related to phonatory stability. Twenty young adults(ten females and ten males) were asked to sustain vowel /a/ for more than 3 seconds under 9 different pitch and loudness conditions. Using MDVP, nine voice samples were analyzed, and jitter percent, fundamental frequency variation, shimmer percent, peak amplitude variation, noise to harmonic ratio, amplitude tremor intensity index, and degree of subharmonics were compared. The results showed that intensity changes can significantly affect various phonatory stability measures, and the lowest perturbation values can be obtained from slightly louder(10dB) phonatory condition than comfortable level phonation.

There are two types of phonetic study, acoustic and physiologic, for differentiating the three manner categories of Korean stop consonants. On the physiologic studies, there are endoscopic, electromyographic(EMG), electroglottographic(EGG) and aerodynamic studies. In this study, I tried to investigate general features of Korean stops using EGG study for the open quotient of vocal fold and baseline shift during speech, and aerodynamic characteristics for e subglottal air pressure, air flow and glottal resistance at consonants. On the aerodynamic study, the glottalized and aspirated stops may be characterized by e increasing subglottal pressure comparing with lenis stop at consonants. The airflow is largest in the aspirated stops followed by lenis stops and glottalized. The glottal airway resistance (GAR) showed highest in the glottalized followed by the lenis, but lowest in e aspirated during e production of consonants, and showed highest in e aspirated, but low in the glottalized and lenis during the production of vowel. The glottal resistance at consonant showed significant difference among consonants and significant interaction between subject and types of consonant. The glottal resistance at vowel showed significant difference among consonants, and e interaction occured between subject and types of consonant. The electroglottography(EGG) has been used for investigating e functioning of e vocal folds during its vibration. The EGG should be related to the patterns of the vocal fold vibration during phonation in characterizing the temporal patterns of each vibratory cycle. The purpose of this study is to investigate the dynamic change of EGG waveforms during continuous speech. The dynamic changes of EGG waveforms fir the three-way distinction of Korean stops were characterized that the aspirated stop appears to be characterized by largest open quotient and smallest glottal contact area of the vocal folds in e initial portion of vocal fold vibration ; the lenis stop by moderate open quotient and glottal contact area ; but the glottalized stop by smallest open quotient and largest glottal contact area. There may be close relationship between the OQ(open quotient) in the initial voice onset and the glottal width at the time of consonant production, the larger glottal width just before vocal fold vibration results in the smaller OQ of the vocal fold vibration in the initial voice onset. The EGG changes of baseline shift during continuous speech production were characterized by the different patterns for the three types of Korean consonants. The small and less stiffness change of baseline shift was found for the lenis and the glottalized, and the largest and stiffest change was found for the aspirated. On the baseline shift for the initial voice onset, they showed so similar patterns with for the consonant production, larger changed in the aspirated. for the lenis and the glottalized during the initial voice onset, three subjects showed individual difference each other. I suggest at s characteristics were strongly related with articulatory activity of vocal tract for the production of consonant, especially for the aspirated stop. The suspecting factors to affect EGG waveforms are glottal width, vertical laryngeal movement and the intrapharyngeal pressure to neighboring tissue during connected spech. So the EGG may be an useful method to describe laryngeal activity to classify pulsing conditions of the larynx during speech production, and EGG research can be controls for monitoring the vocal tract articulation, although above factors to affect EGG would have played such a potentially role on vocal fold vibratory behavior obtained using consonant production.

Recently, many people suffering from voice color change visit otolaryngologist. There is no specific data which can be evaluated objectively for voice color change in korean. In aerodynamic study, maximum phonation time, mean air flow rate, phonatory flow volume and subglottal pressure were tested by using Aerophone II voice function analyzer in korean. 112 male and 122 female aged from 10 to 69 years were randomly selected. Maximum phonation time was 20.8${\pm}$6.4sec in male and 17.2${\pm}$4.1sec in female. Mean air flow rate was 167.1${\pm}$61.4ml/sec. in male and 129.6${\pm}$49.3ml/sec in female. Phonatory flow volume was 3184.5${\pm}$646.0ml in male and 2122.1${\pm}$670.5ml in female. Subglottal pressure was 4.1${\pm}$1.8 cmH2O in male and 3.5${\pm}$1.4cm $H_2O$ in female. There was no statistically significant difference among age groups in all above results.

Incomplete glottic closure of vocal cord atrophy is the common cause of dysphonia. Patients with vocal cord atrophy have complaints such as dysphonia, vocal fatigue, abnormal sensation in the throat, laryngeal pain, cough or sputum like functional voice disorders. Many investigators could not confirm the pathologic laryngeal structure because of their minute pathology. But recent advancements of laryngeal examinations made the many clinicians to detect minimal laryngeal pathology and to have mind the treatment for the vocal cord atrophy. But the results were less effective than their thoughts, the reasons of ineffectiveness were not known well. Authors have found the Hyperfunctional movement of the supraglottis during phonation before and after thyroplasty type I for vocal cord atrophy. Then we have applied the combined modality treatment with thyroplaty type I and voice therapy for relieve of hypefunctional movement of the supraglottis. These options have had more imporved results.

Backgroud : Now a days, most studies for professional voice user have been performed after artificial voice abuse without consideration of environmental and personal factors, and occupational specificity, therefore those studies have some problems. Objectives : To make a basic guideline for the management of untrained professional voice user, practically we ananalyzed the voice of experimental group. Materials and methods : Just after working, the sustained vowel sounds of the 15 female telephone operators (subjective group) and the 20 normal female persons (control group) were analysed, using a history paper, acoustic analyzer and videostroboscopy. Results : The most common symptom in subjective group was dysphonia. Stroboscopic findings in subjective group were as following ; posterior chink 11 cases (73%), incomplete closure 2 cases (13%), anterior chink 1 case (7%). The mean maximal phonation time in telephone operators was 12.8 seconds and in control group was 16.8 seconds. Jitter, pitch pertubation quotient (PPQ), shimmer and amplitude pertubation quotient (ASQ) were significantly increased in subjective group than control group, but there is no difference between two group in fundamental frequency and noise to harmonic ratio. Conclusion : Untrained professional voice user needs professional career guidance and counseling. And when we manage the untrained professional voice user, we should consider specific occupational, personal and environmental factors as well as laryngeal factors.

Anatomic and physiological changes of the larynx with advancing age result in morphologic changes of the vocal fold and reduced control of the phonatory mechanism in elderly individuals and are reflected in increased unstability of fundamental frequency (Fo). The purpose of this study is to increase current understanding of acoustic and stroboscopic characteristics of normal elderly persons voices. First, phonated /a/ vowel productions by 40 normal adults (20 to 40 years, 20 men and 20 women) and 40 normal elderly persons (60 to 80 years,20 men and 20 women) were analyzed, using CSL (model 4300B) acoustic analysis software, to obtain acoustic measures related to fundamental frequency stability nd vocal resonance characteristics. Second, stroboscopic images of the vocal fold behavior in all subjects were analyzed by experienced specialists. In the men, fundamental frequency variation (vFe) (p＜0.01), jitter. (p＜0.05), and shimmer (p＜0.05) for the older group were significantly higher than the value for the adult group. In the stroboscopic findings, edema of vocal fold had a significant finding in aged men (15%). In the women, vFo (p＜0.05), jitter (p＜0.05), and noise to harmonic ratio (NHR) (p＜0.05) for the older group were significantly higher than the value for e adult group and first formant frequency (F1) (p＜0.01) and second formant frequency (F2) (p＜0.01) for. the older group were significantly lower than the value for the adult group. In the stroboscopic findings, vocal fold atrophy had a significant finding in aged women (25%). Frequency stability, as reflected by vFo, jitter, shimmer, and NHR, decreases with advancing age in men and women and spectral analysis of phonated /a/ vowel productions reveals the lowering of the frequency of F1 and second F2 with advancing age, especially in aged women. Change in the mass of vocal folds, due to atrophy or edema, is considered to be the greatest factor in these acoustic changes.

Aberrations in VOT measures in apraxia of speech are indicative of speech motor programming impairment. In English, overlaps of VOT between voiceless and voiced plosives have been frequently observed in patients with apraxia of speech. Unlike English, Korean plosives constitute trichotomy in terms of manner of production, that is, voiceless aspirated /p', t', k'/ ; voiceless or voiced, weakly aspirated /p-b, t-k, k-g/ ; or voiceless, heavily aspirated /p, t, k/. In this spectrographic study, VOT measures during Korean plosives produced by a patient with apraxia of speech were compared to those by age- and gender- matching normal subjects. The results indicated that there were partial overlaps between VOT of /b, d, g/ and those of /p, t, k/, implying that the errors were phonetic in nature. In addition, larger VOT variabilities in apraxia of speech compared to the normals were noted.

Spasmodic dysphonia is an uncommon and poorly understood disorder of motor control of laryngeal speech. We analysed 88 patients with spasmodic dysphonia, using chart review. These patients had historical information evaluated for age of onset(mean 39.2 years), duration of symptoms(mean 8.8 years), sex(4.2 : 1 female to male) family history(positive in 16.7%), and primary(84.8%) and secondary(15.2%) etiology : neurological evaluation for other dystonic involvement(40.7%). Eighty-three patients(94.3%) had adductor type of spasmodic dysphonia and 4 patients were abductor type and 1 patient was mixed type. All patients had normal thyroid and parathyroid functions and among 46cases, 8 patients had abnormal brain MRI finding. seventeen patients were evaluated by auditory brainstem response parameters. four out of the 17 patiemts had prolonged wave Ⅰ-Ⅴ interpeak latency.

In this Paper, we developed an electrolarynx controlled by the EMG(electromyography) of the sternohyoid muscle, and rested the property of the new electrolarynx while normal persons with his own larynx use it. for the examination of property of the developed electrolarynx, our researchers performed three different experiments. The first experiment was tested whether that on/off control of the vibrator of the electrolarynx is synchronized with the activity of the sternohyoid EMG. In the second experiment, it was tested when the lower amplitude of the sternohyoid EMG is produced, whether the higher pitch of the electrolarynx is produced, and vice versa. The third experiment was tested the probability that the electrolarynx can produce the voiceless sound. As the results, we found that the developed electrolarynx had the good produce of the on/off vibrator control and the pitch control of the electrolarynx. Also, we ascertained the possibility that it can produce the voiceless sound.

The mutational falsetto is failure to change from the higher pitched voice of preadolescence to the lower pitched voice of adolescence and adulthood. The one of characteristic findings is contraction of suprahyoid muscles. The large majority of young men with inappropriately high voice have excellent voice therapy prognosis. We have experienced one case of mutational falsetto treated with botulinum toxin injection on suprahyoid muscles. His suprahyoid muscles are contracted markedly simultaneously with each phonation. fundamental frequency$(F_0)$ of his vowel phonation was 332Hz. Extensive voice therapy including manual compression of thyroid notch was ineffective. Forty units of Botox$^{\circledR}$ was injected under the EMG-guidance(20U bilaterally). At seven days post-injection, his voice changed lower than before and at 40 days after procedure, his $F_0$ was 126Hz.

과대비성의 수술적 치료에 있어서 인두측벽의 운동성이 수술 후 어느 정도 남아있는가와 측두문의 크기를 어느 정도 유지하는 것이 적당한가를 결정하는 것이 환자의 만족도를 높이고 좋은 결과를 얻는데 중요한 부분을 차지함을 알 수 있었다.

The clinical investigation was done in the 42 patients with bilateral vocal cord palsy who visited the otorhinolaryngologic department of the Yongdong Severance Hospital during the 10-year period between August 1986 to August 1996. On the sex and age distribution, the ratio of male to female patients was 2.8 : 1 and the age was evenly distributed and average was 46 years old. Of their chief complaints, dyspnea was the most common symptom. Among the position of the paralyzed vocal cords, paramedian position was most common. The most common causes of the bilateral vocal cord palsy was idiopathic Other causes include iatrogenic, prolonged intubation, head ＆ neck trauma, brain tumor, Myasthenia Gravis, and mediastinitis. Our treament results were as follows. Recovery rate of idiopathic bilateral vocal cord palsy was 77.7% and recovery period after bilateral vocal cord palsy was shortened remarkedly after use with steroid. We performed laser arytenoidectomy in patients with irreversible idiopathic vocal cord palsy, neural injury, and cricoarytenoid joint fixation. Decannualtion was possible to be carried out in 86% of the patients and none of complication except for 1 case of aspiration developed. Thus we concluded that it was meaningful surgical treatment of bilateral vocal cord palsy.