• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.18-26
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• 1997

There are two types of phonetic study, acoustic and physiologic, for differentiating the three manner categories of Korean stop consonants. On the physiologic studies, there are endoscopic, electromyographic(EMG), electroglottographic(EGG) and aerodynamic studies. In this study, I tried to investigate general features of Korean stops using EGG study for the open quotient of vocal fold and baseline shift during speech, and aerodynamic characteristics for e subglottal air pressure, air flow and glottal resistance at consonants. On the aerodynamic study, the glottalized and aspirated stops may be characterized by e increasing subglottal pressure comparing with lenis stop at consonants. The airflow is largest in the aspirated stops followed by lenis stops and glottalized. The glottal airway resistance (GAR) showed highest in the glottalized followed by the lenis, but lowest in e aspirated during e production of consonants, and showed highest in e aspirated, but low in the glottalized and lenis during the production of vowel. The glottal resistance at consonant showed significant difference among consonants and significant interaction between subject and types of consonant. The glottal resistance at vowel showed significant difference among consonants, and e interaction occured between subject and types of consonant. The electroglottography(EGG) has been used for investigating e functioning of e vocal folds during its vibration. The EGG should be related to the patterns of the vocal fold vibration during phonation in characterizing the temporal patterns of each vibratory cycle. The purpose of this study is to investigate the dynamic change of EGG waveforms during continuous speech. The dynamic changes of EGG waveforms fir the three-way distinction of Korean stops were characterized that the aspirated stop appears to be characterized by largest open quotient and smallest glottal contact area of the vocal folds in e initial portion of vocal fold vibration ; the lenis stop by moderate open quotient and glottal contact area ; but the glottalized stop by smallest open quotient and largest glottal contact area. There may be close relationship between the OQ(open quotient) in the initial voice onset and the glottal width at the time of consonant production, the larger glottal width just before vocal fold vibration results in the smaller OQ of the vocal fold vibration in the initial voice onset. The EGG changes of baseline shift during continuous speech production were characterized by the different patterns for the three types of Korean consonants. The small and less stiffness change of baseline shift was found for the lenis and the glottalized, and the largest and stiffest change was found for the aspirated. On the baseline shift for the initial voice onset, they showed so similar patterns with for the consonant production, larger changed in the aspirated. for the lenis and the glottalized during the initial voice onset, three subjects showed individual difference each other. I suggest at s characteristics were strongly related with articulatory activity of vocal tract for the production of consonant, especially for the aspirated stop. The suspecting factors to affect EGG waveforms are glottal width, vertical laryngeal movement and the intrapharyngeal pressure to neighboring tissue during connected spech. So the EGG may be an useful method to describe laryngeal activity to classify pulsing conditions of the larynx during speech production, and EGG research can be controls for monitoring the vocal tract articulation, although above factors to affect EGG would have played such a potentially role on vocal fold vibratory behavior obtained using consonant production.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.76-80
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• 2000

Tongue-tip trill is a sound made by the tongue tip making contract with the alveolar ridge and oscillating rapidly as sound is produced. It is an exercise used by many singers to warm up the voice and used as one of the methods of voice rehabilitation for patients who have the vocal folds scarred postoperatively and also who present with a variety of disorders, particularly hypofunction and presbyphonia. We intended to investigate the mucosal vibration of the true vocal folds on tongue-tip trill by electroglottography and to find e effective methods of tongue-tip trill. One adult male volunteer participated. Spectrography and electroglottography were checked repeatedly 15 times, more than 5 second in each times, at same pitch, in three conditions of phonation : sustained /a/ vowel, anterior trill in which tongue-tip vibrated at anterior portion of alveolar ridge just behind the anterior tooth, and posterior trill in which at palatal crest behind the transverse palatine fold We measured the first and second formant to determine indirectly the position of tongue and calculated speed quotient and the ratio of closing phase to closed phase. Speed quotients of posterior trill were higher than sustained /a/ vowel and anterior trill in 14 times. The ratio of closing phase to dosed phase of posterior trill were lower than the others in 14 times. Mucosa of true vocal folds is vibrated more effectively on posterior trill rather than sustained /a/ vowel and anterior trill. So, when tongue-tip trill is used as a method of voice rehabilitation, we suggest that posterior trill is better in producing effective mucosal vibration

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.11-15
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• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.2
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• pp.117-122
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• 2008

Background and Objectives: $Radiesse^{(R)}$ is a gell-formed material of calcium hydroxylapatite (CaHA) and carboxymethylcellulose (CMC) used for vocal fold injections. The authors aimed to study injection laryngoplasty with $Radiesse^{(R)}$, and determine the efficacy of $Radiesse^{(R)}$ for unilateral vocal cord palsy using objective and subjective measures. Materials and Method: Nine patients with unilateral vocal cord palsy received injection laryngoplasty with $Radiesse^{(R)}$ under general anesthesia from Jul. 2007 to Jan. 2008. $Radiesse^{(R)}$ was injected with 25gauze long needle perorally or percutaneously. The Acoustic, aerodynamic, stroboscopic analysis and pre-injection/post-injection perceptual assessment were evaluated in all patients. Results: Postoperative jitter and shimmer scores tended to diminish compared to preoperative scores, and maximum phonation time increased with statistical significantly. Stroboscopic findings demonstrated improvement postoperatively. The degree of hoarseness, which is a part of perceptual assessment, decreased after the procedure. Conclusion: $Radiesse^{(R)}$ may be an altemative material for injection laryngoplasty. We suggest long-term follow up with more cases.

• Speech Sciences
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• v.7 no.3
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• pp.197-218
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• 2000

The vocal tract shapes were measured from tracheoesophageal speakers during the sustained phonation of five Korean vowels /u/, /o/, /a/, /e/, /i/ using magnetic resonance image(MRI). The subject's original vowel utterances with speech intelligibility and the synthesized vowels from MR images were analyzed. The results were as follows: (1) The vowels /a/, /e/, /i/ were perceived as the same sounds of actual subject's speech, but the vowels /o/ and /u/ were perceived as /$\partial$/ and strained /u/, respectively. (2) The synthesized vowels /a/ and /e/ from the MR images were perceived as the same sounds, but the vowels /u/, /o/, /i/ were perceived as different sounds. (3) The synthesized vowel by the expanded pharyngeal segment of 3 times in vowel /o/ was perceived as more natural than that of 2 times. The pharyngeal areas with varied sizes should be experimented to secure better speech production because the correct shapes of the vocal tract lead to distinct vowel production.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.1
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• pp.33-40
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• 2013

Background and Objectives:This study is to objectively compare and analyze the acoustic changes in the patients with total thyroidectomy before and after RI therapy. Subjects and Methods:For this study, a total of 50 patients with total thyroidectomy were participated as subjects. Voice samples were obtained at the time of post-operation (Post-OP), before high-dose radioactive iodine therapy (Pre-RIT), and after high-dose radioactive iodine therapy (Post-RIT). Acoustic analysis, the maximum phonation time and K-VHI (Korea-Voice handicap index) were used for subjective evaluation. Results:According to the comparison analysis of the three periods, mFo (Hz) was significantly reduced in all of the vowels /a/ and /i/ as the hormone was discontinued. This can be related to the reduction in vocal range. As thyroid hormone was discontinued, Shim (%) and APQ (%) values, which are the parameters related to the degree of aggressiveness, showed a significant increase in the middle vowel /a/. As thyroid hormone was discontinued, emotional index was significantly decreased in VHI (voice handicap index). Conclusion:These results can be assumed that thyroid hormone suspension is related to the increased changes in the vocal intensity, the increase in noise and the reduction in vocal range. Emotionally, these data can be assumed that the responsive factors of one's own voice disorders were significantly decreased in the patients with vocal handicap.

• Phonetics and Speech Sciences
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• v.6 no.3
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• pp.3-12
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• 2014

Larynx plays an important role in phonation and protection of the respiratory tract during swallowing. The reduced anatomical and physiological function in elevation of larynx and glottis closure can cause problems in voice and swallowing. The present study investigated the Korean version of handicap index of dysphagia in elderly Koreans. Therefore, 60 normal elderly Koreans ranged from 65 to 95 and 20 normal Korean young adults aged from 20 to 25 were participated in this study to compare total (T), physical (P), functional (F), and emotional (E) index scores between two groups as well as among sub groups (60s, 70s, 80s) in elderly. For swallowing, total and sub dysphagia handicap index (DHI) scores, voice quality during /a/phonation following swallowing (saliva and water), intensity of coughing, and L-DDK were measured. The results showed that functional (P), physical (P), emotional (E) scores as well as total (T) score were significantly different between young adults and old adults in DHI(p<.05). Additionally, there was a negative correlation between total DHI score and intensity of coughing (r=-.51) as well as L-DDK (r=-.70). These findings suggest that a slow rate in vocal fold adduction and reduced intensity of coughing in the elderly affect swallowing function. Thus, recently translated Korean version of DHI may be useful as supplement in evaluating the swallowing problems in elderly people.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.25-29
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• 2016

Background and Objectives : The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. Materials and Methods : from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. Results : Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense$^{(R)}$, Radiessess$^{(R)}$, and Rofilan$^{(R)}$ were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. Conclusion : IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.81-86
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• 2021

Background and Objectives Therapies have been reported to treat the glottal gap previously. However, these voice therapies showed the limits because many techniques focused only on one among breathing, resonance and phonation. In addition patients often have difficulties visiting hospital frequently. 'Gliding and humming' is vocal training technique that readjusts total vocal patterns such as breathing, resonance and phonation. This technique can be easily applied during short term sessions. The purpose of this study is to evaluate the efficiency of voice therapy with 'gliding and humming' for patients with glottic gap during short-term treatment sessions. Materials and Method Twenty-three patients with glottal gap were selected. Of all patients, 14 patients had sulcus vocalis and 12 patients had muscle tension dysphonia (MTD). Voice therapies were performed 1.9 sessions in average. GRBAS, jitter, shimmer, noise to harmonic ratio, semitone range, closed quotient_vowel and maximum phonation time were compared before and after the therapies. In addition, changes of glottal gap and MTD severity were evaluated. Results Statistically significant improvement was observed. MTD improvement was observed only among the patients with glottal gap improvement. Also sulcus vocalis group showed the statistically significant improvement. Conclusion 'Gliding and humming' was effective to the patients with glottic gap and sulcus vocalis. Also, among patients who have both glottic gap and MTD, the data suggests that voice therapy for glottic gap also makes improvement in MTD.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.88-93
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• 2003

Whether respiratory muscle training is of benefit to the singing students is controversial. The purpose of the study is to investigate pulmonary function and the maximal inspiratory(MIP) and expiratory pressure(MET), and maximum phonation time in five female singing students before and after the specially programmed respiratory muscle training during 2 months. All singing students had average 4.8 years of formal classical voice training. Respiratory muscle training machine (Ultrabreath) was used to train respiratory muscle. Pulmonary function test data on simple pulmonary function, flow volume curve, static lung volumes are obtained from Vmax 6200. The MIP and MEP were measured using Spirovis, and the MPT were measured using hand-held stopwatch. Any pulmonary function test variables are not changed after respiratory muscle training. However, MIP and MEP were significantly increased between before and after respiratory muscle training. MPT increased significantly after training, compared to the pre-trained. MIP, MEP, and MPT after training in female singing students were 26%, 25% and 33% higher than those before training. The result indicated that the specially programmed respiratory muscle training is beneficial to improve respiratory muscle strength and vocal function without an increment in pulmonary function.