• 대한후두음성언어의학회지
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• 제31권1호
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• pp.13-18
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• 2020

Background and Objective The purpose of this study is to report the effect of voice therapy using the voice reinforcement method (VRM) in patients with vocal nodules. It is one of the holistic voice therapy methods for improving vocal mechanisms. VRM includes not only direct and indirect voice therapy, but also trial therapy and self-practice. Composed of four stages: vocal hygiene education, relaxation, reinforcement, and generalization. Materials and Methods The subjects were 13 patients who were diagnosed with vocal nodules. Acoustic analysis, auditory perceptual assessment, K-VHI-10 and nodules size were compared before and after voice therapy. Voice therapy was conducted by speech-language pathologist and the mean number was 4.2. Results In acoustic analysis, Jitter, vF₀, vAm, Shimmer, NHR, and VTI were significantly decreased. F₀ was increased after voice therapy for women. 'Grade', 'Rough,' and 'Breathy' were significantly decreased in the GRBAS scale after voice therapy. In addition, K-VHI-10 and nodules size were significantly decreased. Conclusion VRM seems to be an effective voice therapy method in vocal nodules treatment. In VRM, especially, trial therapy is given motivation for vocal nodules treatments and self-practice has a continuous therapeutic effect in everyday life. VRM can be also applied to the voice therapy for other hyper-functional dysphonia.

• Anatomy and Cell Biology
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• 제51권4호
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• pp.232-235
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• 2018

Portal vein provides about three-fourths of liver's blood supply. Portal vein is formed behind the neck of pancreas, at the level of the second lumbar vertebra and formed from the convergence of superior mesenteric and splenic veins. The purpose of this study is to review the normal distribution and variation, morphometry of portal vein and its branches for their implication in liver surgery and preoperative portal vein embolization. It is also helpful for radiologists while performing radiological procedures. A total of fresh 40 livers with intact splenic and superior mesenteric vein were collected from the mortuary of Forensic Department, JSS Medical College and Mysuru Medical College. The silicone gel was injected into the portal vein and different segments were identified and portal vein variants were noted. The morphometry of portal vein was measured by using digital sliding calipers. The different types of portal vein segmental variants were observed. The present study showed predominant type I in 90% cases, type II 7.5% cases, and type III 2.5% cases. Mean and standard deviation (SD) of length of right portal vein among males and females were $2.096{\pm}0.602cm$ and $1.706{\pm}0.297cm$, respectively. Mean and SD of length of left portal vein among males and females were $3.450{\pm}0.661cm$ and $3.075{\pm}0.632cm$, respectively. The difference in the Mean among the males and females with respect to length of right portal vein and left portal vein was found to be statistically significant (P=0.010). Prior knowledge of variations regarding the formation, termination and tributaries of portal vein are very helpful and important for surgeons to perform liver surgeries like liver transplantation, segmentectomy and for Interventional Radiologists.

• Research in Vestibular Science
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• 제17권4호
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• pp.160-166
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• 2018

Objectives: This study was conducted to assess the current management status of the vestibular function test laboratories in Korea. Methods: Questionnaire about the management status of the vestibular function test laboratories was sent by email to the entire members of the Korean Balance Society. The contents of questionnaire included situation of employees who perform the tests, the types of vestibular function tests and equipment, frequency of the test and types of dizziness related questionnaires. Results: Forty-nine hospitals and clinics responded. All the 49 respondents answered that they have videonystagmography. Spontaneous nystagmus analysis by videonystagmogrphy was the most frequently tests for patients with dizziness. Questionnaires for dizziness were used by 27 respondents (55.1%) for initial evaluation of the dizziness patients. The Korean version of dizziness handicap inventory was the most frequently used dizziness related questionnaire. Conclusions: We analyzed the current management status of vestibular function test laboratories to comprehend the present condition of the vestibular function test. We think that these results will help to provide a standard for laboratory operations and prepare for the education, focusing on high-demand tests.

• Journal of Yeungnam Medical Science
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• 제36권2호
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• pp.141-147
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• 2019

Background: The present study aimed to evaluate the clinical association between cadmium exposure and hearing impairment among the Korean population. Methods: This retrospective cross-sectional study used the data obtained from the Korean National Health and Nutrition Examination Survey were used for our study. Finally, 3,228 participants were included in our study, which were then divided into quartiles based on their blood cadmium levels: first quartile (1Q), second quartile (2Q), third quartile (3Q), and fourth quartile (4Q) groups. The hearing thresholds were measured using an automatic audiometer at 0.5, 1, 2, 3, 4, and 6 kHz. Hearing loss (HL) was defined as >25 dB average hearing threshold (AHT). Results: All the groups had 807 participants each. The area under the receiver operating characteristic curves of cadmium level for HL were 0.634 (95% confidence interval [CI], 0.621-0.646). The participants in the 4Q group had higher Low/Mid-Freq, High-Freq, and AHT values than those in the other groups in the multivariate analysis after adjusting for confounding factors. The logistic regression showed that the OR for HL per $1{\mu}g/L$ increase in cadmium was 1.25 (95% CI, 1.09-1.44; p=0.002) on the multivariate analysis. Moreover, the multivariate logistic regression analyses revealed that the participants in the 4Q group exhibited a 1.59-, 1.38-, and 1.41-fold higher odds for HL than those in the 1Q, 2Q, and 3Q groups, respectively. Conclusion: High cadmium level quartile was associated with increased hearing thresholds and HL among the Korean adult population.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.259-266
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• 2018

Objectives. Carcinomas of the external auditory canal (EAC) are rare, and management remains challenging. Previous studies seeking prognostic factors for EAC cancers included cancers other than carcinomas. In this study, we analyzed the treatment outcomes of, prognostic factors for, and survival rates associated with specifically squamous cell carcinoma (SCC) of the EAC. Methods. A retrospective review of 26 consecutive patients diagnosed with SCCs of the EAC in a 10-year period was performed in terms of clinical presentation, stage, choice of surgical procedure, and adjunct therapy. Overall survival (OS) and recurrence-free survival (RFS) were calculated and univariate analysis of prognostic factors was performed. Results. The median age of the 26 patients with SCCs of the EAC was 63 years (range, 40 to 72 years), and 16 males and 10 females were included. According to the modified University of Pittsburgh staging system, the T stages were T1 in 11, T2 in six, T3 in four, and T4 in five cases. The surgical procedures employed were wide excision in three cases, lateral temporal bone resection (LTBR) in 17, and extended LTBR in four, and subtotal temporal bone resection in two. Two patients underwent neoadjuvant chemotherapy, and two underwent adjuvant chemotherapy. One patient received preoperative radiation therapy, and eleven received postoperative radiation therapy. Of the possibly prognostic factors examined, advanced preoperative T stage and advanced overall stage were significant predictors of RFS, but not of OS. Conclusion. The advanced T stage and overall stage were associated with decreased survival after surgical treatment in patients with SCC of the EAC, highlighting the importance of clinical vigilance and early detection.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.267-274
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• 2018

Objectives. Two main digital signal processing technologies inside the modern hearing aid to provide the best conditions for hearing aid users are directionality (DIR) and digital noise reduction (DNR) algorithms. There are various possible settings for these algorithms. The present study evaluates the effects of various DIR and DNR conditions (both separately and in combination) on listening comfort among hearing aid users. Methods. In 18 participants who received hearing aid fitting services from the Rehabilitation School of Shahid Beheshti University of Medical Sciences regularly, we applied acceptable noise level (ANL) as our subjective measure of listening comfort. We evaluated both of these under six different hearing aid conditions: omnidirectional-baseline, omnidirectional-broadband DNR, omnidirectional-multichannel DNR, directional, directional-broadband DNR, and directional-multichannel DNR. Results. The ANL results ranged from -3 dB to 14 dB in all conditions. The results show, among all conditions, both the omnidirectional-baseline condition and the omnidirectional-broadband DNR condition are the worst conditions for listening in noise. The DIR always reduces the amount of noise that patients received during testing. The DNR algorithm does not improve listening in noise significantly when compared with the DIR algorithms. Although both DNR and DIR algorithms yielded a lower ANL, the DIR algorithm was more effective than the DNR. Conclusion. The DIR and DNR technologies provide listening comfort in the presence of noise. Thus, user benefit depends on how the digital signal processing settings inside the hearing aid are adjusted.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.301-308
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• 2018

Objectives. The age-based Cole formula has been employed for the estimation of endotracheal tube (ETT) size due to its ease of use, but may not appropriately consider growth rates among children. Child growth is assessed by calculating the body surface area (BSA). The association between the outer diameter of an appropriate uncuffed-endotracheal-tube (ETT-OD) and the BSA values of patients at 24-96 months of age was our primary outcome. Methods. Cole formula, BSA, age, height, weight and ultrasound measurement of subglottic-transverse-diameter were evaluated for correlations with correct uncuffed ETT-OD. The Cole formula, BSA, and ultrasound measurements were analyzed for estimation rates in all patients and age subgroups. The maximum allowed error for the estimation of ETT-OD was ${\leq}0.3mm$. Patients' tracheas were intubated with tubes chosen by Cole formula and correct ETT-OD values were determined using leak test. ETT exchange rates were recorded. Results. One-hundred twenty-seven patients were analyzed for the determination of estimation rates. Thirteen patients aged ${\geq}72months$ were intubated with cuffed ETT-OD of 8.4 mm and were accepted to need uncuffed ETT-OD >8.4 mm in order to be included in estimation rates, but excluded from correlations for size analysis. One-hundred fourteen patients were analyzed for correlations between correct ETT-OD (determined by the leak test) and outcome parameters. Cole formula, ultrasonography, and BSA had similar correct estimation rates. All three parameters had higher underestimation rates as age increased. Conclusion. The Cole formula, BSA, and ultrasonography had similar estimation rates in patients aged ${\geq}24$ to ${\leq}96months$. BSA had a correct estimation rate of 40.2% and may not be reliable in clinical practice to predict uncuffed-ETT-size.

• Clinical and Experimental Otorhinolaryngology
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• 제11권4호
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• pp.250-258
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• 2018

Objectives. To compare narrative skills between fourth and fifth grades of Persian-speaking students with hearing impairments and typical hearing students of the same grade and also to evaluate the effects of group, sex, hearing age, and educational grade of the students on their spoken/written narrative performance. Methods. The subjects were 174 students aged 10-13 years, 54 of whom wore cochlear implants, 60 suffered from moderate to severe hearing losses and wore hearing aids, with the remaining 60 students being typical hearing in terms of the sense of hearing. The micro- and macrostructure components of spoken and written narrative were elicited from a pictorial story (The Playful Little Elephant) and then scored by raters. Results. Compared to the typical hearing, the students with hearing impairments had significantly lower scores in all of the microstructure components of narratives. However, the findings showed no significant difference among different groups in macrostructure components of narratives. It was also revealed that the students had equal performance in spoken and written narrative. Finally, factor analysis manifested that group, sex, hearing age, and educational level of children might alter the outcome measures in various interactions. Conclusion. Although cochlear implantation was more effective than hearing aid on spoken and written narrative skills, the Persian-speaking students with hearing impairments were seen to need additional trainings on microstructure components of spoken/written narrative.

• 대한후두음성언어의학회지
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• 제32권3호
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• pp.124-129
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• 2021

Background and Objectives This study compares Vocal Fatigue Index (VFI) scores according to the presence or absence of external laryngeal tension in hyperfunctional voice disorder. And through this, it is to confirm the usefulness of VFI to hypertension of extrinsic laryngeal muscles. Materials and Method The subjects were 61 female diagnosed with hyperfunctional voice disorder (hypertension group 41, non-hypertension group 20). The author palpated extrinsic laryngeal muscles for evaluation of hypertension and classified them as the presence or absence. The voice measurements were jitter, shimmer, Korean-Voice Handicap Index-10 (K-VHI-10), and Korean-Vocal Fatigue Index (K-VFI). The voice compared were according to the diagnosis and presence of hypertension only for patients with hyperfunctional voice disorder. Results As a result of comparing the voice measurement according to the presence or absence of hypertension, there was no significant difference in the acoustic variables, K-VHI-10 and K-VFI-Total, K-VFI-Fatigue. Whereas, K-VFI-Physical (p=0.006) and K-VFI-Rest (p=0.022) were significantly higher in the hypertension group. Conclusion These results indicate that the hypertension group has more physical discomfort and less voice recovery than the group without hypertension. It means that K-VFI can measure the physical discomfort and limitations of voice recovery due to hypertension of the external laryngeal muscle. The VFI can be used as one of the methods to evaluate the hypertension of the external laryngeal muscle in Hyperfunctional voice disorder.

• Journal of Audiology & Otology
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• 제24권4호
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• pp.180-190
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• 2020

Background and Objectives: Although many studies have evaluated the effect of the digital noise reduction (DNR) algorithm of hearing aids (HAs) on speech recognition, there are few studies on the effect of DNR on music perception. Therefore, we aimed to evaluate the effect of DNR on music, in addition to speech perception, using objective and subjective measurements. Subjects and Methods: Sixteen HA users participated in this study (58.00±10.44 years; 3 males and 13 females). The objective assessment of speech and music perception was based on the Korean version of the Clinical Assessment of Music Perception test and word and sentence recognition scores. Meanwhile, for the subjective assessment, the quality rating of speech and music as well as self-reported HA benefits were evaluated. Results: There was no improvement conferred with DNR of HAs on the objective assessment tests of speech and music perception. The pitch discrimination at 262 Hz in the DNR-off condition was better than that in the unaided condition (p=0.024); however, the unaided condition and the DNR-on conditions did not differ. In the Korean music background questionnaire, responses regarding ease of communication were better in the DNR-on condition than in the DNR-off condition (p=0.029). Conclusions: Speech and music perception or sound quality did not improve with the activation of DNR. However, DNR positively influenced the listener's subjective listening comfort. The DNR-off condition in HAs may be beneficial for pitch discrimination at some frequencies.