• 대한후두음성언어의학회지
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• 제28권1호
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• pp.25-31
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• 2017

Background and Objectives : Though voice therapy is proven to be effective in academia, treatment results and satisfaction level are inconsistent in clinics. The inconsistency may rise from diverse vocal cords misuse patterns in patient population as they suffer from different diseases or have bad phonation habits. In order to overcome the limitation, we uniformized patients' vocal cords with injection laryngoplasty prior to voice therapy. The efficacy of voice therapy and consistency in treatment results after injection laryngoplasty were assessed. Materials and Methods : Patients diagnosed with vocal nodules were either treated with injection laryngoplasty followed by voice therapy (combined treatment group) or voice therapy only (voice therapy group). Each group consisted of 15 patients. Acoustic measures (jitter, shimmer, NHR), aerodynamic measures (MPT, Psub, MAFR), and subjective auditory conscious measures (K-VHI, K-VRQOL) between two groups were analyzed. Results : After treatments, both groups improved in terms of acoustic, aerodynamic, and subjective auditory conscious measures compared to pre-treatment. Combined treatment group had statistically significantly greater improvement in shimmer, P in K-VHI, and PF in K-VRQOL compared to voice therapy group. Conclusion : Injection laryngoplasty treatment prior to voice therapy synergizes in treating patients compared to voice therapy only.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.112-117
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• 2004

Background and Objectives : This study is purposed to investigate the statistically significant discrimination model for predicting vocal fold nodule and polyp's lesional grade, with patients' background data and objective voice evaluation parameters. Materials and Method : The retrospective research was carried out at the Ewha Womans University Hospital. 122 patients' voice examination data had been selected, and lesion screening (Grade I, II, and III) was conducted by 2 ENT specialists, with each patient's vocal fold pictures achieved during the laryngoscopy examination. Results : The Lesional Grade Discrimination Model with which the lesional grade of vocal fold nodules and polyps could be predicted was derived by the ordinal logistic regression analysis (using SPSS 10.0). With this model the lesional grades of 73 out of 122 patients(59.8%) were correctly predicted to their formerly screened ones. Conclusion : This model applied the multivariate approach, which statistically combined these currently used parameters, Jitter, Shimmer, MFR, MPT, and patient's background data such as gender and dysphonia period. It might explain the status of benign lesion of vocal folds, and furthermore expect the physiological function of vocal folds.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.11.2-11
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• 1983

성대결절 및 성대폴립은 성악인, 교사, 무대예술인 등 음성직업인에게 많이 발생하고 있는 것은 주지의 사실이다. 후두에 경한 염증성 변화가 있을 때 목소리를 남용하면 성대결절이 호발하기 때문에 음성 직업인은 감기 등의 상기도염증이 있을 때는 특히 음성사용에 주의를 기우려야 한다. 성대결절과 폴립이 염증성산물이며 성대의 상피하층의 결체직에서 기원한다는 것은 이미 알려져 있다. 성대의 전 1/3과 중 1/3의 경제부위에 주로 발생하는 것은 그 부위가 진동의 중심부가 되기 때문이다. 이화여자대학교 의과대학부속병원 이비인후과에서 시행한 70예의 후두미세수술 환자를 대상으로 하여 다음과 같은 임상적 고찰을 행하였기에 그 결과를 문헌적 고찰과 함께 보고하는 바이다. 1) 발생초기의 성대결절은 간단한 음성치료로 치유되므로 반드시 결제수술을 시행할 필요는 없다. 2) 소아의 성대결절은 사춘기를 지남에 따라 자연히 소실되는 수가 많으므로 결제수술을 시행하지 않는 것이 좋다. 3) 진행된 성대결절이라 할지라도 음성직업인에게는 우선 3개월 동안 음성치료를 시행하는 것이 좋다. 4) 3개월 동안의 보존적 치료에도 불구하고 성대소견의 개선이 없고 음성장애가 지속되면 후두미세수술을 고려하여야 한다. 5) 수술시에 작은 기도내 삽입관을 사용하여 마취하는 것은 피열간격을 유지하면서 외전된 성대를 유지하는데 필요하다. 6) 성대결절을 제거시 결절을 후방으로 견인하고 그 전방에서부터 제거한다. 7) 어떤 경우에는 결절을 신장시킨 상태에서 감자로 잡고 미세가위나 메스로 절제한다. 8) 음성의 침묵은 술후 일주일동안 시행하며 그 후 일주일은 두사람이 대화할 정도의 약한 목소리를 사용하는 것은 허용해도 좋다.일이내 내원하였으며 25 일 경과후 내원한 경우도 1례가 있었다. 7)식도 및 기도이물의 전례에서 단순 흉부 방사선 촬영을 시행하였고, 이에 나타나지 않은 56례 식도이물을 대상으로 34례에서 식도조영술을 시행하였으며 이중 23례가 양성 소견을 나타냈다. 8) 식도경술에 의해 이물을 제거한 경우는 54례(96.4 %) 였으며, 기관지경술에 의해 이물을 제거한 경우는 14례 (77.8%) 였다. 9 ) 식도 이물에 의한, 또는 식도경술에 의한 합병증이 초래한 경우는 식도점막열상 1례 (1.8 %), 식도 천공 1례 (1.8 %) 였으며, 기도이물에 의한, 또는 기관지경술에 의한 합병증이 초래한 경우는 무기폐 2례 (11.1 %), 폐렴 3례 (16.7 %)로 나타났다.5예에서 소실되었다. 5 ) 청각심리검사 (Psychoacoustic evaluation)에서 폴립은 술전에 Grade 1∼2의 사성이 있었던 11예중 술후 10예에서 Grade 0로 되었으며 Grade 1∼2의 사성이 있었던 3예의 결절에서도 모두 Grade 0로 정상화되었다.>치를 측정한 결과 투여전과 차이가 없었다. 7) 이상의 결과로 볼때 Cis-platinum 사용으로 인한 이중독증은 신장기능이 정상일때는 충분한 hydration으로써 예방이 가능하며 동시에 금기로 알려져왔던 감음성난청이 있는 두경부악성종양환자에서도 세심한 주의하에 적절히 사용한다면 좋은 결과를 얻을 수 있을 것으로 사려된다.은 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다. 1) 이관폐쇄술후 18시간에 최초로 삼출액이 확인되었으며 그 이후는 전실험군에서 삼출성중이염이 유발되다. 2) 도말표본의 세포학적 검사에서 호산구는 전혀 발견되지 않았으며

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2007년도 하계종합학술대회 논문집
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• pp.407-408
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• 2007

Robust pitch estimation is an important study in many areas of speech processing. In voice pathology, diverse statistics extracted form pitch were commonly used to test voice quality. In this study, we compared several established pitch detection algorithms (PDAs) for verification of adequacy of the PDAs. In the database of total pathological voices of 99 and normal voices of 30, an analysis of errors related with pitch detection was evaluated between pathological and normal voices, or among the types of pathological voices such as benign vocal fold lesions; polyp, nodule, and cysts. Consequently, it is required to survey the severity of tested voice in order to obtain accurate pitch estimates.

• 대한후두음성언어의학회지
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• 제9권1호
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• pp.47-52
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• 1998

Objectives : To compare the objective differences in voice quality and voice problems between clergies and normal male control group. Materials and Methods : The sustained vowel sound of 46 clergies and 40 normal persons were analyzed, using a videostroboscopy and acoustic analyzer. Together with these analyses, a questionnaire associated with current and past voice problems was handed over to the patients. Results : The most common symptom in subjective group was the voice fatigue. Stroboscopic findings in subjective group were as following 23 cases(50%) of pachydermia, 17 cases(37%) of phase difference, 12 cases(25%) of anterior-posterior contracture, 6 cases(13%) of vocal polyp and 3 cases(7%) of vocal nodule. The mean maximal phonation time in clergies was 17.8 seconds and in control group was 19 seconds. litter, pitch perturbation quotient and shimmer were significantly increased in subjective group than in control group(p<0.05), but there were no significant differences between two groups in fundamental frequency, vFo, amplitude perturbation quotient and noise to harmonic ratio. Conclusion : In the clergies using loud and forceful voice, vocal polyp and functional voice disorder findings were frequently noted in stroboscopic examination. litter and shimmer, reflecting the roughness of voice, were increased in acoustic analysis. Therefore, clergies, classified into untrained professional voice users, need professional career guidance and counseling.

• 대한후두음성언어의학회지
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• 제29권1호
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• pp.37-40
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• 2018

Background and Objectives : This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. Materials and Methods : The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. Results : Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p<0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p<0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). Conclusion : Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.133-137
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• 2006

Objectives : The purpose of this paper is to know the efficacy of voice therapy for vocal fold nodules in children. Materials and Methods : Sixty two patients with vocal nodules(46 boys and 16 girls) were retrospectively reviewed. Age ranged from 4 to 15 years with mean age of 8 years. Questionnaire survey was carried out with voice handicap index, at pretherapy and post-therapy(3 months and 5 years after voice therapy). Results : Sixty two percent of the patients showed improvement by voice therapy. Twenty five patients continued education at home after voice therapy, but only eight childrens were included this group in pre-school aged children. Voice handicap index was improved in 3 months and 5 years after voice therapy. In contrast, pre-school children group showed slight aggravation in 5 years, especially in emotional subdomain. Conclusion : Voice therapy is effective primary treatment in children with vocal fold nodules. Different result between preschool aged children and school aged group shows needs for age specific approach of voice therapy.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.39-45
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• 2000

Background and Objectives : Accent method is one of holistic approaches for behavior readjustment of voice therapy The aim of this study is to evaluate the efficacy of the accent method of voice therapy for the patients who have no improvement after LMS. Materials and Methods : Of the patients who had been undergone LMS during the period from Jan. 1999 to Dec. 1999, medical records of 38 patients who had not been improved were studied retrospectively. 19 patients(treatment group) were applied accent method and the other 19 patients(control group) refused voice therapy. The voice of all the patients of both group were analysed with CSL and Aerophone II programs in pre- and post operative period. The voice of treatment group were analysed with Visi-Pitch II program before the application of accent method and after the completion of accent method. Then, the results were compared using paired t-test. Results : The results of voice analysis were not different statistically between pre- and postoperative examination in both group. After application of accent method in the treatment group, fundamental frequency(F$_{0}$) of male, relative average pertubation, and shimmer were revealed significant differences(p＜0.01), and decrease in grade(G) scale and roughness(R) scale were statistically Important in perceptual analysis using GRBAS criteria(p＜0.01). But $F_0$ of female, maximal phonation time and S to Z ratio were not revealed significant differences. Conclusions : Accent method of voice therapy may be as a supplement- ary therapy in the patients who were not improved after surgery.

• 재활복지
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• 제22권1호
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• pp.157-168
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• 2018

본 연구는 반폐쇄성도훈련에 기반을 둔 성대에어로빅치료(Vocal Aerobic Treatment: VAT)가 소프라노 성악가 음성개선에 미치는 영향을 알아보고자 하였다. 연구대상은 성대결절로 음성문제를 호소하는 소프라노 성악가 1명으로 연구를 진행하였다. 연구방법은 치료 전 후 음향학적평가와 주관적 음성평가를 실시하여 측정값을 비교하였으며, 성대에어로빅치료는 주 2회 총 32회기동안 진행하였다. 음향학적 평가는 MDVP (multi-dimensional voice program)와 VRP (voice range profile)를 사용하여 음도, 음질, 음역을 평가하였으며, 주관적 음성평가는 SVHI (singing voice handicap index)로 주관적인 음성만족도를 평가하였다. 음도 평가 결과 치료 후 소프라노 가수에 적절한 기본주파수(Fo)를 유지하였다. 음질평가 결과 주파수변동률(Jitter), 진폭변동률(Shimmer), 배음대소음비(NHR) 수치가 치료 전보다 감소하였다. 음역평가결과 음역의 범위가 넓어졌으며 반음의 개수가 30개에서 35개로 증가하였다. 주관적 음성평가는 설문 보고 후 획득한 총 점수를 문항수로 나눈 결과 3.6점에서 0.6점으로 감소하였으며, 본인이 느끼는 음성문제의 정도가 경미하다고 보고하였다. 이러한 결과를 정리해보면 성대에어로빅치료는 성악가 음성개선에 효과적인 것으로 사료된다. 그러나 본 연구는 소프라노 성악가 1명을 대상으로 한 성대에어로빅치료의 치료 효과에 관한 사례연구로 향후 더 많은 성악가를 대상으로 효과에 대한 연구가 이루어져야 할 것이다. 또한 성악가뿐만 아니라 다양한 직업적 음성사용자를 위한 음성관리 및 음성치료프로그램에 관한 후속 연구가 필요할 것이다.

• 대한후두음성언어의학회지
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• 제24권1호
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• pp.47-50
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• 2013

Background and Objectives:The purpose of this study is to find features in acoustics and to learn useful features of parameters in order to distinguish laryngeal diseases through many acoustic variables. Materials and Methods:The subjects of this study were 125-male patients who had been diagnosed with vocal nodule, vocal polyp, vocal cyst, Reinke's edema, leukoplakia. To research the features of each disease in acoustics, they are measured 34 parameters by using MDVP. Results:It is clear that in order to see a meaning result when distinguishing laryngeal diseases, $F_0$, $MF_0$, $T_0$, Fhi, Flo, PER variables are significant (p<.05). It means that variables related to fundamental frequency are important to anticipate which group will be diagnosed with Reinke's edema and leukoplakia. vAm had an effect on getting a significant result in terms of amplitude perturbation parameters, which is useful to distinguish between laryngeal polyp/cyst and other laryngeal disease (p<.05). ATRI made a significant result in related to tremor parameters, which is useful to distinguish between laryngeal polyp and other laryngeal disease (p<.05). Conclusion:$F_0$, $MF_0$, $T_0$, Fhi, Flo, PER, vAm, ATRI might be meaningful parameters distinguishing pathologic from benign laryngeal diseases. Especially, the vAm and ATRI are an important factor when forecasting which group would be diagnosed with vocal polyp.