• Title/Summary/Keyword: 발성장애

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Controversies in Management of Functional Dysphonia (기능성 음성 장애 치료의 고려사항)

  • Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.86-89
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    • 2014
  • Functional dysphonia (FD) is a voice disorder in the absence of structural or neurologic laryngeal pathology. FD is not a single disease but a disease entity. Therefore several voice disorders, which have completely different pathogenesis, are included in this category. The first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. Several different treatment modalities are included in the managements of FD. Voice therapy is in charge of the main role in treatment of FD. Medical treatment is also necessary when patient has general problems which would affect voice production. Vocal folds mucosal lesions can cause FD even the lesion is minor. In this case proper surgical intervention helps to improve the symptom of FD. Psychiatric consultation should be considered when the patient has psychological problems.

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Comparison of Clinical Characteristics and Polysomnographic Findings between REM Sleep Behavior Disorder with and without Associated Central Nervous System Disorders (중추신경계질환 동반 여부에 따른 렘수면 행동장애의 임상 특성과 수면다원기록소견 소견 비교)

  • Lee, Yu-Jin;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.58-63
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    • 2005
  • Objectives: REM sleep behavior disorder (RBD), characterized by excessive motor activity during REM sleep, is associated with loss of muscle atonia. In recent years, it has been reported that RBD has high co-morbidity with CNS disorders (especially, Parkinson's disease, dementia, multiple system atrophy, etc.). We aimed to assess differences in clinical and polysomnographic findings among RBD patients, depending on the presence or absence of central nervous system (CNS) disorders. Methods: The medical records and polysomnographic data of 81 patients who had been diagnosed as having RBD were reviewed. The patients were classified into two groups: associated RBD (aRBD, i.e., with a clinical history and/or brain MRI evidence of CNS disorder) and idiopathic RBD (iRBD, i.e., without a clinical history and/or brain MRI evidence of CNS disorder) groups. Twenty-one patients (25.9%) belonged to the aRBD group and 60 patients (74.1%) belonged to the iRBD group. The clinical characteristics and polysomnographic findings of the two groups were compared. Results: Periodic limb movement disorder (PLMD), i.e., PLMI (periodic limb movement index)>5, was observed more frequently in the aRBD group than in the iRBD group (p<0.001, Fisher's exact test). Also, obstructive sleep apnea syndrome (OSAS), i.e., RDI (respiratory disturbance index)>5, was found more frequently in the aRBD group (p=0.0042, Fisher's exact test). The percentages for slow wave sleep and sleep efficiency were significantly lower in the aRBD group than in the iRBD group. Conclusion: We found that 1 out of 4 RBD patients had associated CNS disorders, warranting more careful neurological evaluation and follow-up in this category of RBD. In this category of RBD patients, we also found more frequent PLMD and OSAS. These patients were also found to have lower slow wave sleep and sleep efficiency. In summary, RBD patients with associated CNS disorders suffer from more disturbed sleep than those without them.

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A Case of Malignant Lymphoma of the Larynx (후두에 발생한 원발성 악성임파종 1례)

  • 우훈영;고건성;이희배;전시영;오경균;백만기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.6.3-6
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    • 1978
  • The purpose of this paper is to review the literature concerning the occurence of malignant lymphoma of the larynx and to add a case. Mackenty was the first to report a case of malignant lymphoma involving the larynx, 1934. After then 28 cases were reported of which 8 were described as primary in the larynx. Yet no case was reported in our nation. We experienced a case of primary malignant lymphoma of the larynx in 10 years old male and report with consideration of literature concerning the same disease.

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Development of Differential Diagnosis Scale Items for Adductor Spasmodic Dysphonia and Evaluation of Clinical Availability (내전형 연축성 발성장애 감별진단 문항 개발과 임상적 유용성 평가)

  • Cho, Jae Kyung;Choi, Seong Hee;Lee, Sang Hyuk;Jin, Sung Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.112-117
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    • 2019
  • Background and Objectives The purpose of this study was to develop the differential diagnosis scale containing items from adductor spasmodic dysphonia (ADSD) to muscle tension dysphonia (MTD) and the determine clinical utility of newly developed items. Materials and Method The four parts of pitch, redirected phonation, automatic speech and voiced sound were selected for analyzing the characteristics of ADSD in the literature. One part of tense voiceless sound was developed according to the Korean manner of articulation. The content validity was evaluated based on 5 scales (1-5 point) analysis from 30 experts. One hundred patients (50 ADSD and 50 MTD) were recorded in reading a sentence and sustained phonation. The two speech language pathologist evaluated recorded voices through a blind test using 4 scales (0-3 point) for newly developed items. Results As a result of verifying the content validity of items with experts, it was identified that the differentiated items were valid with 4.2 out of 5. Through the differential diagnosis between two groups according to the items, the correlation between sub-domains and total scores was shown as higher than 0.710. The result of analyzing the reliability on each diagnosis domain was 0.840-0.893, which showed the internal consistency of items was great. Newly developed five parts of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). The reliability among the evaluators was analyzed as high with 0.892. Conclusion In this study, the differential diagnosis scale of ADSD was revealed as having validity and reliability. It is considered that it will be useful for differentiating ADSD and MTD in the clinical field.

A Case of Thyroarytenoid Myoneurectomy Using LASER and Monopolar Electrical Device in Spasmodic Dysphonia (연축성 발성장애 환자에서 레이저와 단극성 전기소작기를 이용한 갑상피열근신경 절제술 1예)

  • Lee, So Jeong;Jung, Soo Yeon;Chung, Sung Min;Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.132-135
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    • 2019
  • Spasmodic dysphonia is a focal laryngeal dystonia that results in involuntary spasms during speech. The etiology of spasmodic dysphonia is not yet defined, but it is presumed to be a neurological abnormality of central nervous system motor function. The treatment of choice for spasmodic dysphonia is botulinum toxin injection directly at the laryngeal muscles. However botulinum toxin injection requires repeated procedures. Many different kinds of surgical treatments have been introduced but the recurrence rate is still high. So we performed myomectomy with LASER and neurectomy with specially designed electrical surgical knife which can cut recurrent laryngeal nerve branch selectively with its noble curved section. We report a case of a 43-year-old male patient with spasmodic dysphonia treated by thyroarytenoid myoneurectomy.

Aerodynamic Characteristics of Young and Elderly Adult Patients with Voice Disorders during Continuous Speech (젊은 성인 및 노인 음성장애 환자의 연속발화시 공기역학적 특성 비교)

  • Pyo, Hwa-young
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.270-278
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    • 2019
  • This study was performed to compare the aerodynamic characteristics of young and elderly adult male patients with voice disorders during continuous speech. Aerodynamic measurements were obtained after 12 young male patients and 9 elderly male patients read a paragraph. The elderly group showed longer duration, lower airflow rate and air volume than the younger group, but the differences were not significant except phonation time. So, when interpreting the meaning of aerodynamic measures of elderly voice disorder patients in the aspects of airflow and air volume, it should take into account various conditions(e. g. reading materials, pulmonary functions) as well as age.

Management of Anterior Glottic web with Laser Vaporization and Silastic Keel Insertion (성대전연부 격막의 레이저치료 및 endolaryngeal silastic keel 삽입술의 효과)

  • 최종욱;정도광;김용환;오재훈;허경회
    • Proceedings of the KSLP Conference
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    • 1993.12a
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    • pp.21-21
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    • 1993
  • 발성장애와 호흡곤란을 주소로 하는 성대 전연부 격막은 후두병변의 부적절한 치료, 만성염증 또는 외상 등의 후천적인 원인으로 발생하는 경우가 많다. 성문중 가장 협소한 부위인 전연부에 발생한 격막에 대하여는 여러 가지 다양한 치료방법이 보고되고 있지만, 재협착의 가능성이 높고, 치료후 반흔 조직에 의하여 음성의 질을 높이는데 한계점이 있다. (중략)

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Thyroplasty type III for high pitched voice (제 3 형 갑상연골성형술에 의한 병적인 고음성치료)

  • 홍기환;전동석;김영중
    • Proceedings of the KSLP Conference
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    • 1993.12a
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    • pp.22-22
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    • 1993
  • 병적인 고음성은 임상적으로 흔하지는 않지만 종종 볼 수 있는 질환으로서 치료에 대한 많은 논란이 있는 게 사실이다. 대개 음성교육에 의한 치료가 많이 시행되며 수술적인 치료로서는 제 3형 갑상연골성형술이 인정되어 온 것이 사실이다. 이러한 수술에 대한 적응증으로는 첫째 남자에서 오랫동안 너무 높은 음성(mutational voice disorder)을 가진 환자와 둘째 여러 가지 원인에 의해 성대가 너무 경직되어 고음이면서 애성(breathy voice)을 동반한 발성장애가 있겠다. (중략)

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Trill 발성시 전기성문파 측정법상에서 나타난 성대점막운동의 변화

  • 진성민;반재호;이경철;권기환;이용배
    • Proceedings of the KSLP Conference
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    • 1999.11a
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    • pp.176-176
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    • 1999
  • 배경 : trill은 혀의 첨부가 호기에 따라 진동하면서 경구개 전방에 부딪혀 나는 소리로 주로 "르" 발음으로 들린다. trill은 성악가들에게는 발성전에 후두의 준비운동으로 사용되고, 성대수술 반흔에 의한 애성환자나 노인성 음성장애환자의 음성치료에도 이용되고 있다. 목적 : trill을 실시할 때 전기성문파 측정법상에서 나타난 성대점막의 움직임을 조사하고 효과적인 trill 기법을 찾아보고자 하였다. (중략)

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