• 대한후두음성언어의학회지
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• 제28권2호
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• pp.106-111
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• 2017

Background and Objectives : The purpose of this study was to investigate the criterion-related concurrent validity of two standardized auditory-perceptual assessments and the Acoustic Voice Quality Index (AVQI) for measuring dysphonia severity in patients with vocal cord paralysis (VCP). Materials and Methods : Total 210 patients with VCP and 236 normal voice subjects were asked to sustain the vowel [a:] and to read aloud the Korean text "Walk". A 2 second mid-vowel portion of the sustained vowel and two sentences (with 26 syllables) were recorded. And then voice samples were edited, concatenated, and analyzed according to Praat script. Two standardized auditory-perceptual assessment (GRBAS and CAPE-V) were performed by three raters. Results : The VCP group showed higher AVQI, Grade (G) and Overall Severity (OS) values than normal voice group. And the correlation among AVQI, G, and OS ranged from 0.904 to 0.926. In ROC curve analysis, cutoff values of AVQI, G, and OS were <3.79, <0.00, and <30.00, respectively, and the AUC of each analysis was over .89. Conclusion : AVQI and auditory evaluation can improve the early screening ability of VCP voice and help to establish effective diagnosis and treatment plan for VCP-related dysphonia.

• 대한후두음성언어의학회지
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• 제18권1호
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• pp.51-55
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• 2007

Objectives: The aim of this study is to compare the efficacy of fresh versus frozen reconstituted botulinum toxin type A (BTX-A) for the treatment of adductor type spasmodic dysphonia. Materials and Methods: After reconstitution with normal saline, BTX-A was used within 4 hours or it was kept frozen in a consumer grade freezer at about $-25^{\circ}C$ for up to 4 months. Thirty patients with spasmodic dysphonia were randomly assigned and treated with the either fresh or frozen BTX-A. About 83% of injections resulted in a satisfactory outcome with 5.3 months of mean action duration. Treatment outcomes and side effects of total 161 injections were compared along the duration of keeping BTX-A frozen. Results: There were no statistical differences in the duration of action, self-rated satisfaction score, and the duration of hoarseness and/or aspiration between fresh and frozen BTX-A treated groups. No significant side effects were observed and the frozen BTX-A were proved to be free of bacterial contamination. Conclusion: After being reconstituted and kept frozen, BTX-A may be safely used for more than 4 months without significant loss of its effectiveness or additional side effects.

• 대한후두음성언어의학회지
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• 제33권2호
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• pp.103-109
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• 2022

Background and Objectives The Voice Perceived Present Control scale (VPPC) has been developed to provide better insight into patients' perceived control over their thoughts or behaviors related to voice disorders. The objective of the present study was to validate the Korean VPPC (K-VPPC) by evaluating its internal consistency and reliability. Materials and Method All items of the English VPPC were translated into Korean. Content validity was analyzed through three Delphi survey rounds by an expert panel (n=44) with active clinical and research experience in treating dysphonic patients. Twenty-three patients with a heterogeneous diagnosis of dysphonia and twenty-three gender-matched vocally normal controls (total n=46) were asked to complete the K-VPPC and the Korean Voice Handicap Index-10 (KVHI-10). Psychometric properties including internal consistency and reliability were evaluated to examine the appropriateness of cross-cultural use of K-VPPC. Results Cronbach's alpha coefficient of K-VPPC was 0.89 for dysphonic patients, indicating good internal consistency in clinical samples. Furthermore, patients with dysphonia scored significantly lower on the total score of K-VPPC and higher on voice handicap than the vocally normal controls. Spearman's correlation coefficients indicated an inverse and moderate association between the K-VPPC and all domains of KVHI-10 (Spearman's r=-0.44- -0.68). Conclusion The findings of the current study indicated that the K-VPPC is a valid and reliable tool for the assessment of perceived control in Korean patients with dysphonia. Therefore, the K-VPPC could be a useful and complementary tool for the comprehensive evaluation of dysphonia, thereby improving care in Korean patients with voice disorders.

• 말소리와 음성과학
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• 제8권2호
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• pp.73-80
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• 2016

The purpose of this study was to analyze perceptual and spectral/cepstral measurements in patients with adductor spasmodic dysphonia(ADSD). Sixty participants with gender and age matched individuals(30 ADSD and 30 controls) were recorded in reading a sentence and sustained the vowel /a/. Acoustic data were analyzed acoustically by measuring CPP, L/H ratio, mean CPP F0 and CSID, and auditory-perceptual ratings were measured using GRBAS. The main results can be summarized as below: (a) the CSID for the connected speech was significantly higher than for the sustained vowel (b) the G, R and S for the connected speech were significantly higher than for the sustained vowel (c) Spectral/cepstral parameters were significantly correlated with the perceptual parameters, and (d) the ROC analysis showed that the threshold of 13.491 for the CSID achieved a good classification for ADSD, with 86.7% sensitivity and 96.7% specificity. Spectral and cepstral analysis for the connected speech is especially meaningful on cases where perceptual analysis and clinical evaluation alone are insufficient.

• 대한후두음성언어의학회지
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• 제16권2호
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• pp.146-151
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• 2005

Objectives: Prospective study of quality of life in patients underwent microlaryngeal surgery for dysphonia was performed. Materials and Methods : 51 patients with dysphonia took part in the study, and patients with malignancies or functional voice disorder were excluded. Patients were asked to complete the SF-36 questionnaire before surgery and within 6-12 months after surgery. Preoperative and postoperative SF-36 scores were compared with data on 46 age-matched healthy controls. Results The most of SF-36 subscale scores showed significantly improvement after surgery, except of PF (physical functioning) and MH (mental health). Preoperative scores had significantly poorer than the normal controls on 6 subscales, but there is no statistically significant differences between postoperative scores and normal controls on 5 subscales. Conclusion In the study, patients with organic voice disorder show improvement in quality of life after microlaryngeal surgery.

• 음성과학
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• 제12권4호
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• pp.203-213
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• 2005

This study was conducted to investigate the respiratory and aerodynamic function of adductor spasmodic dysphonia (ADSD) patients. Participants were (1) 18 females SD patients with non- Botulinum toxin injection (2) 14 females SD patients who had taken treatment of Botulinum toxin injection. (3) 14 age- and sex- matched normal female controls. Spirometer and phonatory function analyzer were used for respiratory muscle pressure (MIP: Maximum inspiratory pressure), MEP: Maximum expiratory pressure)& MPT(Maximum phonation time) and aerodynamic(F0:Fundamental frequency, intensity, MFR: Mean flow late, Psub: Subglottal pressure) measurement. The results were as follows: (1) Normal group was significantly higher in MIP, MEP, MPT than two SD groups (p < .05); (2) MPT was significantly lower in SD with non-Botulinum toxin injection group than SD with the treatment experience of Botulinum toxin injection (p < .05); (3) All aerodynamic parameters, F0, intensity, MFR, Psub, were not significantly different among three groups(p > .05).The reason of short MPT in ADSD may use lower respiratory pressure than normal group as strategy to decrease their tremulous voice quality. Moreover respiratory muscle pressure was lower than normal group regardless of botulinum toxin injection treatment.

• 대한후두음성언어의학회지
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• 제32권2호
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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.

• 대한후두음성언어의학회지
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• 제32권2호
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• pp.64-74
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• 2021

Background and Objectives This study was to investigate the voice quality and articulation effects of laryngeal massage on muscle tension dysphonia (MTD). Materials and Method A systematic review of articles published between January 2000 and December 2020 in Cochrane, PubMed, ScienceDirect, SpingerLink, ERIC, and Naver Academic was conducted. From the total of 2094 articles identified, 10 peer-reviewed articles were included in a meta-analysis. Mean effect sizes of the variables related to voice quality (jitter, shimmer, harmonic to noise ratio or noise to harmonic ratio, high-F0, low-I, cepstral peak prominence) and articulation (F1, F2, F1 slope, F2 slope) were calculated by Hedges'g. Results Meta-analysis of the selected articles showed that laryngeal massage had medium to large effects on all variables of voice quality and articulation except F0-high and F1 slope in the MTD patients. Conclusion This study provided comprehensive clinical evidence that it is highly desirable to apply laryngeal massage to MTD patients.

• 대한후두음성언어의학회지
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• 제30권2호
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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.

• 말소리와 음성과학
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• 제12권4호
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• pp.91-98
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• 2020

근긴장성 발성장애(cepstral peak prominence, MTD) 환자의 모음 발성과 문장읽기 과제를 켑스트럼 기반 변수를 이용하여 분석하였으며 음성장애 환자의 GRBAS청지각적 특성과 음향학적 특성의 상관관계를 살펴보고, 랜덤포레스트 머신러닝 분류 알고리듬을 이용한 MTD 감별 진단 가능성을 논의하였다. 내원 시 MTD로 진단받은 여성 36명과 정상음성을 사용하는 여성 36명이 연구에 참여했으며, 수집한 음성샘플은 ADSVTM를 사용하여 분석하였다. 연구 결과, 음향학적 측정치 중 MTD의 CSID(cepstral spectral index of dysphonia)는 대조군보다 높았으며, CPP(cepstral peak prominence), CPP_Fo 값이 대조군보다 유의하게 낮았다. 이는 모음 발성과 읽기 과제에서 모두 동일하게 나타났다. MTD 환자의 음질 특성은 전반적인 음성중증도(G)가 가장 두드러졌으며, 조조성(R), 기식성(B), 노력성(S)순으로 음성 특성을 보였다. 이 특성이 높아질수록 CPP가 감소하는 부적 상관을 보이고, CSID는 증가하는 정적 상관이 관찰되었다. 켑스트럴 변수 중 모음과 문장읽기과제 모두에서 집단간 유의한 차이를 보여준 CPP와 CPP_F0를 이용하여 MTD와 대조군의 음성분류를 시도하였다. 머신러닝 알고리듬인 랜덤포레스트로 모델링한 결과 문장읽기 과제에서 모음연장발성보다 조금 더 높은 분류 정확도(83.3%)가 나왔으며, 모음 발성과 문장 읽기 과제 모두에서 CPP변수가 더 중심적 역할을 수행하였음을 알 수 있었다.