• Speech Sciences
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• v.9 no.4
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• pp.15-25
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• 2002

It's not easy to produce very high tones during singing for not only untrained ordinary people but also even trained singers. To get high singing tones from the low tones, some trained singers used to use a distinguished singing technique, Passaggio (vocal register transition). The purpose of this study is to compare several voice parameters variation between when to sing with using the passaggio technique and to sing without using it. We selected 18 male singers (tenor 8, baritone 10), who had more than 7 years of experience and were well trained in passaggio technique. Simultaneous measurements of fundamental frequency (F0), mean flow rate (MFR), intensity (I), and subglottal pressure (Psub) were performed using the phonatory function analyzer (Nagashima). For the tenor, target tones /a/ were presented: 1) easy phonation: $B_{2}$, 2) high tone without passaggio: F$#_{3}$ 3) high tone with passaggio: F$#_{3}$. For the baritone, target tones /a/ were presented: 1) easy phonation: G$#_{3}$, 2) high tone without passaggio: D$#_{3}$, 3) high tone with passaggio: D$#_{3}$. F0 of the target tones between non-passaggio group and passaggio group was almost the same in both tenor and baritone groups. Intensity of the non-passaggio and passaggio vocalization was much louder than that of easy phonation and pasaggio was louder than non-passaggio vocalization (especially statistically significant in baritone singers). MFR of the passaggio vocalization was greater than non-passaggio vocalization in both tenor and baritone group, but statistically significant only in baritone. Psub of the passaggio vocalization was greater than that of the non-passaggio vocalization in both tenor and baritone group, but statistically not significant in tenor.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.18-22
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• 2002

Background and Objectives : It has been pointed out that alcohol intake in human beings induces changes in voice register and maximum phonation time. These changes supposedly result from injection of the vibratory vocal folds. The purpose of this study was to clarify the voice changes associated with alcohol intake and the changes of laryngeal mucosa. Materials and Methods : The subjects included 29 volunteers, including 20 men and 9 women ranging in age from 22 to 31 years. Alcohol intake was accomplished by oral administration of 23% soju 1 bottle (255cc). Serum alcohol concentration levels were evaluated hourly for 3 h after ingestion of alcohol. Seven measurements were performed at pre-alcohol intake and post-alcohol intake hourly : fundamental frequency, jitter, shimmer, noise to harmonic ratio as the acoustic analysis, maximal phonation time, mean flow rate, and subglottal pressure as the aerodynamic analysis. The changes of laryngeal mucosa were evaluated by flexible laryngoscope at each measurement. Results : By comparing the acoustic and aerodynamic data and laryngeal mucosa before and after alcohol intake, there were not remarkable changes (p>0.05). Conclusion : The voice and laryngeal mucosa have not remarkably changed according to alcohol concentration in this study. Furthermore studies on the voice change induced by multiple alcohol concentrations are required.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.119-125
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• 2011

Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.163-171
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• 2009

This study attempted to investigate vocal characteristics and differences in gender and voice classification among classical singers. Twenty-three female singers (M = 23.1 yrs, SD = 3.6 yrs, average 6.3 yrs singing experience, all classified as sopranos) and twenty male singers (M = 25.2 yrs, SD= 3.6 yrs, average 6. 3 yrs singing experience, 8 tenors, 12 baritones) were recruited to participate in the present study. Speaking fundamental frequency (FO), closed quotient (CQ), MPT (Maximum Phonation Time), breathing types, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and singers' formants were measured. In addition, vibratory patterns were observed using stroboscopy. Sfo, singing CQ, breathing types, formant frequency in singers' formants, MIP, MEP, and MPT were significantly different from gender to gender. Generally, singers' formants were observed in male singers and also the pattern of singers' formants was different between tenors and baritones. Lower singing CQ values were observed than speaking CQ values in the female singers (P<.001). Furthermore, MEP, MIP, and singing CQ were significantly lower for female singers than for males singers (P<.001). MPT and speaking FO, however, were not significantly different between tenors and baritones.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.146-160
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• 2000

The current study aimed to establish rationales for using three different voice therapies (resonant voice, accent method, and tongue-tip trills) by comparing the aerodynamic, and vocal fold closure characteristics under three therapies. A total of 8 male under/graduate students(tenors) participated as subjects. In order to compare aerodynamic characteristics, air flow rates and subglottal pressures were measured using Phonatory function analyzer under three therapy conditions. The characteristics of vocal fold closure patterns also were examined by comparing closed quotients(CQ) measured by Electroglottograph(EGG) under three therapy conditions. However, maximum phonation time (MPT) was measured under only resonant voice and tongue-tip trills using Aerophone II. The results are summarized as follows : 1) CQ, subglottal pressure and MPT decreased significantly under resonant voice as compared with throat voice, but the air flow rate increased significantly under resonant voice. 2) CQ decreased significantly under accent method as compared with throat voice, but both air flow rate and subglottal pressure increased significantly under accent method. 3) Both CQ and MPT decreased significantly under tongue tip trills as compared with throat voice, but air flow rate and subglottal pressure increased significantly under tongue-tip trills. Clinical implications of results were discussed in light of differential effects of three voice therapies.

• Phonetics and Speech Sciences
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• v.10 no.2
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• pp.69-76
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• 2018

The elderly are at increased risk of developing dysphagia due to aging and illnesses. The aim of the current study was to analyze, via an acoustic study, the change in the voice quality of normal elderly people after a 3oz water-swallow test. Subjects included a group of 60 normal elderly people (age: $mean{\pm}SD=76.9{\pm}6.66$) and 60 healthy young adults (age: $mean{\pm}SD=25.1{\pm}2.36$). Every participant produced a five-second /a/ phonation pre- and post-swallowing, and the fractioned two-second sections were analyzed using the MDVP (multi dimensional voice program) analysis. The elderly group demonstrated a post-swallowing increase in the following related acoustic parameters: fundamental frequency, fundamental frequency variation, amplitude-variation, and noise in both two-second sections. However, the younger group showed an increase only in frequency related acoustic parameters (i.e., STD ) in the first two-second section. The significant changes in values in the post-swallowing parameters might indicate temporary irregularities in pitch and amplitude along with higher amounts of noise in the voice. The results could be attributed to water residues in the vocal fold and vocal tract, as well as a deterioration of the motor and sensory functions caused by anatomical and physiological changes that result from aging.

• 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.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.8.2-9
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• 1983

Recently, the laryngomicrosurgery has been done for the removal of benign laryngeal mass and for the improvement of voice. For the evaluation of the effect of the treatment, there must be any objective method such as aerodynamic study, vocal fold vibration study, acoustic analysis, psycho-acoustic evaluation and the neuro-muscular study. The authors evaluated the phoniatric effect of the laryngomicrosurgery for the patients of 15 laryngeal polyps and 9 laryngeal nodules, who received pre-op. and post-op. vocal function study from Jun. 1981 to Mar. 1983. The results obtained were as follows ; 1) The post-op. mean value of the maximum phonation time was increased 40 % in the unilateral polyps, 62 % in the bilateral nodules and 18 % in the unilateral nodules. 2) The post-op. mean value of the phonation quotient was decreased 25 % in comparison with pre-op. value in the case of the bilateral polyps, 26 % in the unilateral polyps, 55 % in the bilateral nodules and 12 % in the unilateral nodules. 3) The post-op. mean value of the mean air flow rate was decreased 27 % in comparison with the pre-op. value in the case of the bilateral polyps, 25 % in the unilateral polyps, 65 % in the bilateral nodules, 25 % in the unilateral nodules. 4) The glottic chink of the 10 cases of polyps among the 11 cases were disappeared, and the glottic chink of the 5 cases of nodules among 7 cases were also disappeared after surgery. 5) The pre-op. hoarseness of the 10 cases of polyps among the pre-op. hoarseness of the 11 cases of polyps were changed to clear and the 3 cases of nodules were also changed to clear.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.30-36
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• 2018

Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.16-20
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• 2004

Purpose : To assess perceptual, acoustic and aerodynamic measure of voice quality in patients with unilateral vocal cord paralysis before and after type I thyroplasty. Methods : The clinical records of patients operated type I thyroplasty in the Departement of otorhinoalryngolgy, Yongdong Severance hospital from November 2001 to November 2003 were reviewed. All patients uderwent a vocal function evaluation including perceptual, acoustic and aerodynamic measures of voice preoperative and on $60^{th}$ postoperative day. The perceptual and acoustic measures were obtained from recording of patients' reading a 'Sanchak' passage. The perceptual evaluation was performed by 2 speech pathologist using a 4-point rating scale. Acoustic parameters(voice range profile low(RAL), voice range profile high(RAH), average fundamental frequency(AFX), closed quotient, harmonic to noise ratio, jitter and shimmer) were investigated by Lx speech studio. Mean flow rate(MFR), subglottic pressure(Psub) and intensity were measured using the Phonatory function analyzer. The maximum phonation time was also measured. The data were statistically analyzed. A paired t-test (p<0.1) was used to compare preoperative and postoperative results. And multiple regression test was used to find which parameter was most correlated to improvement of postoperative voice quality. Results : Among aerodynamic parameters, Psub $(88.11mmH_2O{\rightarrow}58.7mmH_2O)$, MPT(7.87sec${\rightarrow}$12.53sec), MFR (359.8ml/sec${\rightarrow}$161.06ml/sec) were statistically improved. AFx(205.5Hz${\rightarrow}$163.27Hz), AQx(23.9%${\rightarrow}$48.3%), RAL, RAH. Jotter and shimmer were improved. In multiple regression test, AFx and AQx was noted as the two meost correlated parameters to improvement of postoperative breathiness. But general grade of voice quality was more correlated to Psub and shimmer. Conclusion : Vocal fold medialization procedures effectively reduce glottic gap. Increasing of contact area of both vocal folds induced improvement in aerodynamic parameters and leaded stabilizing of vocal fold vibration. That effect results in improvement in acoustic parameters (shimmer, jitter, signal-to-noise ratio, voice range profile) and voice quality.