• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.146-160
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• 2000

The current study aimed to establish rationales for using three different voice therapies (resonant voice, accent method, and tongue-tip trills) by comparing the aerodynamic, and vocal fold closure characteristics under three therapies. A total of 8 male under/graduate students(tenors) participated as subjects. In order to compare aerodynamic characteristics, air flow rates and subglottal pressures were measured using Phonatory function analyzer under three therapy conditions. The characteristics of vocal fold closure patterns also were examined by comparing closed quotients(CQ) measured by Electroglottograph(EGG) under three therapy conditions. However, maximum phonation time (MPT) was measured under only resonant voice and tongue-tip trills using Aerophone II. The results are summarized as follows : 1) CQ, subglottal pressure and MPT decreased significantly under resonant voice as compared with throat voice, but the air flow rate increased significantly under resonant voice. 2) CQ decreased significantly under accent method as compared with throat voice, but both air flow rate and subglottal pressure increased significantly under accent method. 3) Both CQ and MPT decreased significantly under tongue tip trills as compared with throat voice, but air flow rate and subglottal pressure increased significantly under tongue-tip trills. Clinical implications of results were discussed in light of differential effects of three voice therapies.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.2
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• pp.133-139
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• 2001

Background and Objectives : There are so many methods to investigate the causes of voice disorders. However, they were almost invasive or non-physiologic methods. And none of them showed the laryngeal movements. Phonation pharyngogram is non-invasive method to see the laryngeal movement directly. Authors studied to evaluate the availability of phonation pharyngogram in laryngeal nodule. Materials and Methods : 30 laryngeal nodules and 10 control groups were evaluated. Acoustic analysis and maximum phonation time were measured and pharyngogram was taken during sustaining /a/ phonation immediately after swallowing the barium. We measured the width of hypopharyngeal wall, shape of hypopharyngeal wall and pyriform sinus apex, level difference between both true vocal folds, angle of subglottis, location of true vocal folds, elevated distance of vocal folds and shape of c-spine. Results : Jitter, Shimmer of laryngeal nodule were higher than control group and maximum phonation time was shorter in laryngeal nodule. There was a significance in width of hypopharyngeal wall, shape of pyriform sinus apex, level difference between both true vocal folds, elevated distance of vocal folds and shape of c-spine. Conclusions : Authors knew that there were differences when we used the phonation pharyngogram between normal group and laryngeal nodule group.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.117-123
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• 2002

MIP was significantly increased in singers, compared to the untrained group. MIP in patients showed decreasing tendency compared to the untrained group, but were significantly lower than that in singers. MEP in singers was higher than that in the untrained group. MPT increased significantly in singers, but diminished in patients compared to the untrained group. MIP, MEP, and MPT in male singers were 50.8%, 61.0%, and 28.7 % higher than those in female singers. MIP, MEP, and MPT in the untrained male were more increased 32.3%, 25.0%, and 28.7%, respectively than those in the untrained female. There was no correlation between MPT and MIP or MEP. Regression analysis of the data set showed that weight and vocal cord dysfunction was a positive predictor of MPT. Factors affecting MIP were male, singers and weight. Factors affecting MEP were male, singers, vocal cord dysfunction and weight.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.98-103
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• 2000

Background and Objectives : The etiology and pathophysiology of spasmodic dysphonia is yet unknown. This study was performed to determine if any laryngeal aerodynamic parameter distinguish the voice of patient diagnosed as having adductor spasmodic dysphonia from individuals with normal voice production and to investigate the pathophysiology of spasmodic dysphonia. Materials and Methods : fifteen women diagnosed as having adductor spasmodic dysphonia and fifteen normal control women participitated in this study Maximum phonation time, mean air flow rate, subglottic pressure, vocal efficiency, Vfo, NHR, VTI, FTRI, ATRI, Jitter percent, Shimmer percent were obtained from the participants using 'MDVP(multi-dimensional voice program)' of CSL(Computerized Speech lab, Kay Elemetrics, Co., Model No. 4300), and 'maximum sustained phonation' and 'IPIPI test' of AP II(Aerophone II, Kay Elemetrics, Co., Model 6800). Results : T-test statistical analysis revealed statistically different values for vocal efficiency, Vfo, NHR, MPT, litter percent, Shimmer percent between the spasmodic dysphonia group and the control group. Conclusions : Spasmodic dysphonia affects the ability of the laryngeal mechanism to function effectively. Results from our study demonstrate that certain aerodynamic and acoustic parameters distinguish adductor spasmodic dysphonia from normal voice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.146-148
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• 2006

Spasmodic dysphonia is a voice disorder characterized by involuntary voice breaks during speech. Adductor spasmodic dysphonia is most common and characterized by strained and strangled voice breaks. The current standard of treatment of therapy for adductor spasmodic dysphonia is chemodenervation of thyroarytenoid muscle with botulinum toxin(Botox). However, Botox is a temporary treatment with each injection lasting approximately 3 months on average and require repeated injections. In this study, we report our experience with surgical treatment for adductor spasmodic dysphonia. In this procedure, the thyroarytenoid branch and lateral cricoarytenoid branch of recurrent laryngeal nerve is selectively denervated unilaterally, and its distal nerve stump of thyroarytenoid branch is reinnervated with branch of the usa cervicalis nerve. And lateral cricoarytenoid muscle partial myotomy was done unilaterally. After 6 months of treatment, voice fluency had improved and no period of breathiness or dysphagia was noted.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.106-110
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• 2011

Western classical singing voices are different from those of pop song singer's singing voices as well as traditional Korean singing such as Pansori. We anlalysed the singing voices from three different categories with using free application programs available at the usual smart phones : sound level meter and Spectral View Analyzer and fiberoptic rhinolaryngoscopic evaluation. The intensity of voice produced by a classical western singer was 11 dB louder than that produced by a pop song singer. Source sound, glottic sound, as well as harmonic sound and singing resonant sound (Singer's formant) are much more prominent. When evaluated under video-rhinolaryngoscopy during singing, the resonance cavity especially oropharyngeal cavity and hypopharyngeal cavity are widely opened during singing of the western classical singer than those of the traditional Korean singer's singing. Difference of singing methods including producing the glottal sound, respiration and resonance are discussed. Possible explanation of development of 'Singer's Formant' is discussed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.17-21
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• 2010

Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.12-14
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• 2019

Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.94-97
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• 2021

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO₂ laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.