• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.3
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• pp.183-187
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• 2022

Dysphonia is well known as one of the otolaryngological symptoms of coronavirus disease 2019 (COVID-19) infection. The vocal changes of the COVID-19 condition have been reported in terms of parameters of multi-dimensional voice assessment, including acoustic analysis, auditory-perceptual evaluation, and psychometric assessment. However, there has not been a daily followup study in patients with acute COVID-19 infection. In this study, a 41-year-old male performed daily voice recordings of vowel phonation and passage-reading tasks during the self-quarantine period of one week. Compared to the normal voice status of the prepandemic period, voice abnormalities peaked on day two after the diagnosis of COVID-19 infection and recovered after one week.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.2
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• pp.89-96
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• 2022

Background and Objectives The quality of life after thyroidectomy, such as voice change, is considered to be as important as control of the disease. In this study, we aimed to evaluate changes in both subjective and objective voice parameters after thyroidectomy resulting in normal morbidity of the vocal cords. Materials and Method In this prospective cohort study, 204 patients who underwent thyroidectomy with or without central neck dissection at a single referral center from Feb 2015 to Aug 2016 were enrolled. All patients underwent prospective voice evaluations including both subjective and objective assessments preoperatively and then at 2 weeks, 3, 6, and 12 months postoperatively. Temporal changes of the voice parameters were analyzed. Results Values of the subjective assessment tool worsened during the early postoperative follow-up period and did not recover to the preoperative values at 12 months postoperatively. The maximal phonation time gradually decreased, whereas most objective parameters, including maximal vocal pitch (MVP), reached preoperative values at 3-6 months postoperatively. The initial decrease in MVP was significantly greater in patients undergoing total thyroidectomy, and their MVP recovery time was faster than that of patients undergoing lobectomy (p=0.001). Patients whose external branch of the superior laryngeal nerve was confirmed intact by electroidentification showed no difference in recovery speed compared with patients without electroindentification (p=0.102), although the initial decrease in MVP was lower with electroidentification. Conclusion Subjective assessment in voice quality and maximal phonation time after thyroidectomy did not show recovery to preoperative values. Aggravation of MVP was associated with surgical extent and electroidentification.

• Phonetics and Speech Sciences
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• v.9 no.3
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• pp.85-91
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• 2017

The present study aimed to investigate the changes of acoustic parameters of the aspirated voice in stroke patients. The eighty-eight subjects diagnosed with cerebro-vascular accident were divided into 32 penetration/aspiration (P/A) and 56 Non-P/A groups according to the videofluroscopic swallowing study (VFSS) results, and 26 control subjects participated. All subjects preformed VFSS and vowel /a/ was recorded three times pre- and post VFSS. Since the variation in the acoustic parameters within a single phonation has been observed, we proposed a delta formula for the acoustic parameters which can reflect the temporal changes of the each parameter in an utterance. We measured from the voice data eight acoustic parameters: fundamental frequency (F0), standard deviation of F0 (F0_SD), Jitter, relative average perturbation (RAP), Shimmer, amplitude perturbation quotient (APQ), harmonic to noise ration (HNR), noise to harmonic ratio (NHR). Then we found parameters which show the meaningful biggest temporal change in an utterance using the suggested delta parameter. Among them, the deltas of shimmer and APQ were significantly different pre- and post VFSS. These deltas of the P/A and the control group were increased after VFSS, while those of the Non-P/A group was descended. The variation patterns of the P/A and the control group were similar but the change width of the P/A group was larger. The large variations in an aspirated phonation of the P/A group are thought to be caused by irregular changes in air resistance due to residual food on the vocal cords.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.8.2-8
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• 1982

Hoarseness is the change of voice quality which represents the abnormal function of phonation and is the main symtom of the laryngeal diseases. The etiology of hoarseness are known more than 50 causes, among them, viral upper respiratory infection is the main cause of hoarseness and the laryngeal nodule and polyp, laryngeal paralysis, laryngeal cancer, laryngeal papilloma and the laryngeal tuberculosis are the other causes of hoarseness in that order. Recently, the authors experienced 4 cases of uncommon etiology of hoarseness, so we present the cases with the brief review of literatures. Case 1. 29 years old male Admitted in Dept. of neurosurgery due to Traffic Accident. He had a trauma on the anterior neck. Hoarseness was developed on 1 month after the accident. Laryngoscopic finding; Paramedian paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 2. 53 years old male Admitted in Dept. of General Surgery due to Clonorchis Sinensis, under the general endotracheal anesthesia, Choledochostomy was performed. Laryngoscopic finding; Median paralysis of left vocal cord. Case 3. 56 years old male Admitted in Dept. of Internal Medicine due to Aortic Aneurysm. Hoarseness was developed on 3 months prior to admission. Laryngoscopic finding; Intermediated position paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 4. 74 years old male Admitted in Dept. of Internal Medicine due to Bronchogenic carcinoma. Hoarseness was developed on 3 years prior to admission. Laryngoscopic finding; Paramedian paralysis of right vocal cord.

• Speech Sciences
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• v.10 no.2
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• pp.111-128
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• 2003

Aerodynamic study is valuable information about the vocal efficiency in translating airflow to acoustic signal. The purpose of this study was to investigate the differences between trained singers and untrained controls under different two pitch by simultaneous using the airway interruption method and electroglottography (EGG). Under singing a Korean lied 'Gene', 20 (Male 10, Female 10) trained singers were studied on two one-octave different tone. Mean flow rate (MFR) , subglottic pressure (Psub) and intensity were measured with aerodynamic test using the Phonatory function analyzer (Nagashima Ltd. Model PS 77H, Tokyo, Japan). Closed quotients (Qx), jitter and shimmer were also investigated by electroglottography using Lx speech studio (Laryngograph Ltd, London, UK). These data were compared with those of normal controls. MFR and Psub were increased on high pitch tone in all subject groups. Statistically significant increasing of Qx and intensity were observed in male trained singers on high pitch tone (Qx;p = .025, intensity;p < .001). Beacasue of increasing of Qx and intensity, vocal efficiency was also significantly increased in male singers (p < .001). The trained singers' phonation was more efficient than untrained singers. The result means that the trained singers can increase the loudness with little changing of mean flow rate, subglottic pressure but more increasing of glottic closed quotients.

• Speech Sciences
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• v.8 no.2
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• pp.23-37
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• 2001

The primary sound produced by the vibration of vocal folds reaches the velopharyngeal isthmus and is directed both nasally and orally. The proportions of the each component is determined by the anatomical and functional status of the soft palate. The oral sounds composed of oral vowels and consonants according to the status of vocal tract, tongue, palate and lips. The nasal sounds composed of nasal consonants and nasal vowels, and further modified according to the status of the nasal airway, so anatomical abnormalities in the nasal cavity will influence nasal sound. The measurement of nasal sounds of speech has relied on the subjective scoring by listeners. The nasal sounds are described with nasality and nasalization. Generally, nasality has been assessed perceptually in the effect of maxillofacial procedures for cleft palate, sleep apnea, snoring and nasal disorders. The nasalization is considered as an acoustic phenomenon. Snoring and sleep apnea is a typical disorders due to abundant velopharynx. The sleep apnea has been known as a cessation of breathing for at least 10 seconds during sleep. Several medical and surgical methods for treating sleep apnea have been attempted. The uvulopalatopharyngoplasty(UPPP) involves removal of 1.0 to 3.0 cm of soft palate tissue with removal of redundant oropharyngeal mucosa and lateral tissue from the anterior and sometimes posterior faucial pillars. This procedure results in a shortened soft palate and a possible risk following this surgery may be velopharyngeal malfunctioning due to the shortened palate. Few researchers have systematically studied the effects of this surgery as it relates to speech production. Some changes in the voice quality such as resonance (nasality), articulation, and phonation have been reported. In view of the conflicting reports discussed, there remains some uncertainty about the speech status in patients following the snoring and sleep apnea surgery. The study was conducted in two phases: 1) acoustic analysis of oral and nasal sounds, and 2) evaluation of nasality.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.75-80
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• 2021

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly. Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared. Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved. Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient's vocalization and improving voice quality, pitch and loudness.

• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.97-102
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• 1996

The larynx has three major functions such as protective reflex, respiration and phonation, and is richly innervated by sensory, sympathetic and parasympathetic nerves. The sensory innervation of the laryngeal mucosa, which is involved in the perception of pain, mechanical and chemical irritation, prtects the airway via various laryngeal reflexes. We studied the distribution of Substance P (SP) and Calcitonin Gene-Related Peptide (CGRP) sensory fibers in the rat's larynx using the immuno-histochemical methods. Many SP and CGRP immunoreactive fibers were found in all regions of the laryngeal mucosa except the vocal cords. SP immunoreactive fibers showed a very similar distribution to the CGRP fibers in the epithelium and submucosa. But SP immunoreactive fibers were sparser than CGRP immunoreactive fibers in distribution density. Both reactive fibers were denser in the supraglottic region than subglottic region. Especially, intraepithelial fibers displayed the densest innervation to the laryngeal surface of the epiglottis. h the subepithelium, SP and CGRP immunoreactive fibers were distributed along the wall of vessels and around the glands. The present results suggest that the regional distribution of SP and CGRP immunoreactivity may be responsible for the protective reflex function of the laryngeal inlet.

• Phonetics and Speech Sciences
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• v.3 no.2
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• pp.99-105
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• 2011

The treatment for patients with mutational dysphonia typically is useful with vegetative phonation, but has not yet been studied. This study attempts to identify the effect of $SKTCLP^{(R)}$ using throat clearing and laughing in patients with mutational dysphonia. The study, which was designed by the author, included 26 patients aged from 14 to 32 years (mean: 18.7 years) who had been diagnosed with mutational dysphonia between January 2007 and June 2010. Voice therapy for these patients included $SKTCLP^{(R)}$, ranging from two to seven sessions (mean: 3.8 sessions). Results were evaluated by videostroboscopy, perceptual evaluation of GRBAS scale, aerodynamic test, and acoustic analysis before and after therapy. Most patients could phonate with low pitch from the beginning and sustain with normal pitch sound in the last session. We had found that glottic gap reduced after therapy and anterior-posterior compression of superior laryngeal part at the first time, and these patients had complete closure of the glottis after treatment. The results of acoustic and aerodynamic measures after treatment indicated significant decreases in Fo, Jitter, Shimmer, SFF, and SPI, and increases in MPT, Psub, and vocal efficiency (p<.05). $SKTCLP^{(R)}$ may be a useful treatment method in managing mutational dysphonia. We can suggest this technique may be useful in improving the voice quality of other functional dysphonia having glottal chink or functional aphonia.