• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.7 no.1
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• pp.56-60
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• 1996

The vocal efficiency(VE) can be calculated as the ratio of acoustic power to aerodynamic power. It relates to the vocal intensity, air Sow rate and subglottic pressure. In this study, we treated 20 cases of vocal polyps and 10 cases of vocal nodules by way of laryngo-microsurgery or laser laryngo-microsurgery. The VE was measured preoperatively and postoperatively in all cases. The results showed that there was a significant improvement of VE postoperatively than that of preoperative measurement(p＜0.01) in vocal Polyp group. However, there was no significant difference(p＞0.05) in vocal nodule group. Through comparing the results, we obtained the conclusion : The laryngo-microsurgery is the reliable method of management for the vocal polyps, but f3r the vocal nodules, the laryngo-microsurgery should be selected after other more conservative approaches fail to produce the desired results.

• 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 Korean Critical Care Nursing
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• v.2 no.2
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• pp.42-55
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• 2009

Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.70-70
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• 1993

Fundamental frequency is controlled by contraction of both TA and CT muscle. While activity of the CT is known well, little is known regarding the effect of the TA muscle on vocal fold vibration. To study this, a previously developed in vivo canine laryngeal model was modified. Isolated TA muscle activation was obtained by stimulating sectioned terminal TA branches through small thyroid cartilage windows. The results indicated that TA muscle activation is a major determinant in vocal register shift from falsetto to modal phonation. F0 increased with increasing TA activation in modal register, On the other hand, the F0 decreased with TA activation when the evoked voice belonged to falsetto register. Subglottic pressure increased gradually and OQ decreased gradually with TA activation.

• Phonetics and Speech Sciences
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• v.7 no.4
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• pp.93-99
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• 2015

In case of PAS test, the air is sometimes leaked although the mask is tightly attached to the face, which is not reliable on the measured values. Therefore, this study aimed to assist the clinical practice suggesting the test method of PAS without air leakage. In the healthy subjects with 12 males and 12 females over 19 years old, three types of tests were performed on the voicing efficiency among the protocol of PAS Model 6600. They are; first, to attach the mask tightly to the face holding the handle of PAS with the subject's two hands (Method 1); second, to attach the mask tightly to the face holding the handle of PAS with the subject's one hand and pushing the body of PAS strongly with the other hand (Method 2); and third, to attach the mask tightly to the face pushing the upper part of the mask by the tester when the subject attached the mask to his or her face holding the handle of PAS with two hands (Method 3). Upon the study analyses, the mean negative pressure, the mean phonogram, subglottic air pressure, and voicing efficiency were shown to be statistically significantly different during PAS test in males depending on the methods. (p<.05) In case of females, only the target airflow rate showed significant difference depending on the methods during PAS test. (p<.001) In conclusion, Method 2 enhanced the noise level and strength while Method 1 was likely to leak the air more compared to the other two methods in males. In case of females, Method 1 showed significant leakage of the air flow. Not to allow the air flow leakage without affecting the outcome of PAS test, it will be the most useful for the tester to push the mask to the subject's face tightly (Method 3).

• Speech Sciences
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• v.5 no.1
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• pp.121-139
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• 1999

Our experimental subject was a laryngectomee who had undergone total laryngectomy with $PROVOX^{(R)}$ insertion, and learned esophageal speech after the surgery, so he could produce both $PROVOX^{(R)}$ voice and esophageal voice. With this subject's production of $PROVOX^{(R)}$ and esophageal voice, we are to compare the acoustic and aerodynamic characteristics of the two voices, under the same physical conditions of the same person. As a result, the fundamental frequency of esophageal voice was 137.2 Hz, and that of $PROVOX^{(R)}$ was 97.5 Hz. $PROVOX^{(R)}$ voice showed lower jitter, shimmer and NHR than esophageal voice, which means that $PROVOX^{(R)}$ voice showed better voice quality than esophageal voice. In spectrographic analysis, the formation of formants and pseudoformants were more distinct in esophageal voice and several temporal aspects of acoutic features such as VOT and closure duration were more similar with normal voice in $PROVOX^{(R)}$ voice. During the sentence utterance, esophageal voice showed longer pause or silence duration than $PROVOX^{(R)}$ voice. Maximum phonation time and mean flow rate of $PROVOX^{(R)}$ voice were much longer and larger than esophageal voice, but mean and range of sound pressure level, subglottic pressure and voice efficiency were similar in the two voices. Glottal resistance of esophageal voice was much larger than $PROVOX^{(R)}$ voice which showed still larger glottal resistance than normal voice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.1
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• pp.5-11
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• 1999

Background and Objectives : Recently, many people suffering from voice change visit otolaryngologist. So, it is important to study vocal function in patients with glottic or laryngeal disease. Aerodynamic investigation is valuable information about the efficiency of the larynx in translating air pressure to acoustic signal. The purpose of this study was to investigate the aerodynamic data in patients with vocal polyp, compare this data with that of the normal Korean. Materials and Methods : 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 157 normal korean and 143 patients with vocal polyp, aged from 20 to 69 years randomly selected. Results and Conclusion : In vocal polyp, maximum phonation time was significantly decreased and mean air How rate was increased. Phonatory flow volume was significantly decreased and subglottic pressure was increased only in female with vocal polyp. These data will be served as basic data of evaluation after treatment and postoperative assessment of the patients with vocal polyp.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.2
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• pp.141-144
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• 2004

Background and Objectives : To compare acoustic, aerodynamic analysis of voice and intelligibility score in patients with near-total laryngectomy and implantation of Provox prothesis. Material and Methods : In order to evaluate the voice characteristics, acoustic, aerodynamic parameter and speech intelligibility were measured in 5 patients after near-total laryngectomy, 5 patients after implantation of Provox prosthesis with total bility were measured in 5 patients after near-total laryngectomy, 5 patients after implantation of Provox prosthesis with total laryngectomy and 10 adults normal speaker. Acoustic analysis was carried out using CSL and aerodynamic analysis was carried out using Aerophon II. Speech sample was recorded and 10 listener was scored for speech intelligibility using a percentage of words correctly identified. Results. Fundamental frequency($F_0$), intensity, jitter, shimmer, maximal phonation time(MPT), subglottic air pressure were used for parameters for voice analysis. There were no significant difference between two group except on fundamental frequency and shimmer. The fundamental frequency was higher in patients with near-total laryngectomy and shimmer was higher in patients after implantation of Provox prosthesis with total laryngectomy. In addition, speech intelligibility was no significant difference between two groups. Conclusion : This results confirm that near-total laryngectomy and implantation of Provox prosthesis provides good voice rehabilitation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.38-42
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• 2008

Background and Objectives : This study was performed to investigate the perceptual and aerodynamic characteristics and the relation between vocal efficiency and the severity of strained voice. of adductor spasmodic dysphonia. Materials and Methods : 13 female patients with adductor spasmodic dysphonia were examined and compared with 10 normal female control group. MPT, MFR, Psub, Sound Intensity, VE(vocal efficiency) were obtained using PAS(Phonatory Aerodynamic System). GRBA(S) scale was used for Perceptual evaluation. Results : Psub(subglottic pressure) of SD was significantly higher than normal group. MPT, MFR, Sound Intensity, VE were not significantly different between two groups. Correlation between VE and 'S'(strained) was not significant. Conclusion : The results of this study show that certain aerodynamic parameters(Psub) distinguish adductor spasmodic dysphonia from normal voice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.118-123
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• 2019

Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.