• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.12-14
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• 2019

Functional dysphonia (FD) is a disease entity which includes various voice disorders in the absence of structural or neurologic laryngeal pathology. Muscle tension dysphonia (MTD), psychogenic dysphonia are representative FD with completely different pathogenesis. Therefore there is no standard treatment modality for FD, the first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. MTD is a functional voice disorder caused by hyperfunction of intrinsic and extrinsic laryngeal musculature. Symptoms include increased vocal effort, roughness, fatigue and odynophonia. First line for MTD is indirect or direct voice therapy. Unfortunately, many patients with MTD improve with voice therapy alone. For these patients, various modalities tried; lidocaine application, surgical excision of the false vocal folds, and botulinum toxin injection, etc. Botulinum toxin injections are widely used in the field of otolaryngology, especially for spasmodic dysphonia. However, its use in FD or MTD has only been described in few case reports. The aim of this lecture is to evaluate the feasibility of botulinum toxin injection for FD, especially MTD.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.269-274
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• 2017

This study aimed to investigate the acoustic differences that occur in diverse sections of sustained vowel phonation, which is often used in an objective speech analysis of voice disorder patients. The subjects included 17 voice disorder patients (vocal nodules) and 12 normal individuals without any voice disorder. The participants' sustained vowel phonation of /a/ was divided into onset, middle, and offset, and the jitter, shimmer, and NHR in each section were analyzed using the MDVP(Multi-Dimensional Voice Program). The Friedman test and post hoc analysis were used. In the vocal nodules group, the jitter, shimmer and NHR were significantly higher in the off section of sustained vowel phonation than in the middle section, and there were no significant differences between the beginning and middle sections. In contrast, in the group of normal individuals, there were no significant differences between any of the sections. The values of the acoustic parameters according to the section of analysis in the sustained vowel phonation are different and the vocal in the end section is significantly more unstable than that in the middle section. The results of this study will be useful for selecting the sections to be analyzed in sustained vowel phonation and interpreting the results of the analysis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.53-58
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• 1998

Objectives : To compare the voice quality and voice problems of untrained professional voice user groups with that of normal control group without voice problem. Materials and Methods : The sustained vowel sounds of 13 male and 36 female teachers, 46 clergies and 15 telephone operators, and 40 normal male and 20 normal female persons were analyzed, using a videostroboscopy and acoustic analyzer. Together with these analyses, a questionnaire associated with risk factors for current and past voice problems was handed over to the patients. Results : The most common symptom in subjective groups was the voice fatigue. In stroboscopic examination, the professional voice user groups shelved functional voice disorder findings regardless of the Intensity of voice use. In the clergy and teacher using loud voice, vocal polyp, vocal nodule and hyperfunction of laryngeal muscle were frequently observed. In the clergy and telephone operator, jitter and shimmer were significantly increased. In the female teacher, the value of jitter, fundamental frequency variation and fundamental frequency were statiscally significant. However, the voice of male teacher showed no significant findings in the acoustic and aerodynamic studies. Conclusion : In the management of voice problems for untrained professional voice user groups, it is important to find the exact causes and patterns of voice problems, and to be individualized the management according to the causes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.437-446
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• 2008

Electroglottography (EGG) is a simple and non-invasive technique for analyzing the vibratory patterns of the vocal folds by detecting impedance changes across the larynx. An abnormal electroglottogram is shown in patients who have a dysphagia associated with neuromuscular disorder. Electroglottography offers reliable informations for diagnosis of swallowing disorder and gives quantitative datas. The purpose of this study is to provide the normal value of electroglottography in normal adults. We took electroglottograms of 80 adults who have no problem in swallowing and utterance. EGG data were analyzed to find out the value of Pitch, Jitter and Closed quotient with a commercially available software. There were significant differences between a usual voice and loud voice in 3 measures on the EGG signalmean pitch, Avg. jitter, mean quotient. To get a proper electroglottography, phonation of a usual voice was better than a loud voice. Four measurements- S.D pitch, Avg. Jitter, Mean closed quotient, S.D closed quotient- were independent of sex for adult. Three measurements- Mean pitch, S.D pitch, Mean closed quotient - were independent of age for adult aged twenties to fifties. The Avg. Jitter of twenties appeared to be lower than those of forties and fifties. The S.D closed quotient of twenties appeared to be lower than those of thirties, forties and fifties.

• Phonetics and Speech Sciences
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• v.7 no.4
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• pp.77-83
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• 2015

Voice complication without the laryngeal nerve injury can occur after thyroidectomy. The purpose of this study is to investigate voice changes according to extent of thyroidectomy with acoustic analysis. Thirty-five female patients with papillary thyroid carcinoma took voice evaluation at before and 1 month, and 3 months after thyroidectomy. Acoustic analysis parameters were speaking fundamental frequency(SFF), min $F_0$, max $F_0$, dynamic range $F_0$, jitter, shimmer, noise-to-harmonic ratio(NHR), and Cepstral prominence peak(CPP). Repeated-measured analysis of variance was applied. Time-related voice changes showed significant differences in all parameters except NHR. At 1 month after surgery, voice quality was worse and pitch was decreasing, but voice quality and pitch were improving at 3-month follow-up. Voice changes according to the extent of surgery were in SFF, max $F_0$, and dynamic range $F_0$. Time by surgery-related voice change existed only in min $F_0$. The result showed that the severity of voice complication depended on the extend of thyroidectomy which had a negative impact on $F_0$-related parameters. The deterioration of voice quality at 1 month after thyroidectomy may be affected by the loss of thyroid hormone in the blood. The descent of $F_0$-related parameters may be impacted by laryngeal fixation of surgical site adhesion.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.164-167
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• 1998

Myasthenia gravis is a neuromuscular disorder that affects striated muscles especially those innervated by the cranial nerves. Most patients present with symptoms relating to the head and neck and thus may be seen first by the otolaryngologist. Recently we had experienced a case of myasthenia gravis with the complaints of hypernasality and voice fatigue in a 49 year old male. In this case, all symptoms were improved markedly with administration of anticholinesterase.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.225-231
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• 1997

The persistent and recurrent dysphonia after microlaryngeal surgery was noted in tweleve patients. We reviewed the results of laryngostroboscopy, psychoacoustic evaluation, aerodynamic study and acoustic analysis according to the treatment modality. The causes of persistent dysphonia were attributed to vocal cord scarring, recurrent mass lesion, residual mass lesion, persistent inflammation, and hyperfunctional voice disorder. We noticed the better vocal function in the group treated with voice therapy or surgical therapy than the group treated with voice rest and medication. Therefore, we concluded that vocal function can be improved with the use of active, multidisciplinary approach which includes voice therapy, medical treatment and selected surgical resection according to the laryngeal lesions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.94-97
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• 2021

Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO₂ laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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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.

• Phonetics and Speech Sciences
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• v.11 no.3
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• pp.69-76
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• 2019

This study aimed to investigate the effects of vocal aerobic treatment (VAT) on the improvement of voice in patients with voice disorders. Twenty patients (13 males, 7 females) were diagnosed with voice disorders on the basis of videostroboscopy and voice evaluations. Acoustic evaluation was performed with the Multidimensional voice program (MDVP) and Voice Range Profile (VRP) of Computerized Speech Lab (CSL), and aerodynamic evaluation with PAS (Phonatory Aerodynamic System). The changes in F0, Jitter, Shimmer, and NHR before and after treatment were measured by MDVP. F0 range and Energy range were measured with VRP before and after treatment, and the changes in Expiratory Volume (FVC), Phonation Time (PHOT), Mean Expiratory Airflow (MEAF), Mean Peak Air Pressure (MPAP), and Aerodynamic Efficiency (AEFF) with PAS. Videostroboscopy was performed to evaluate the regularity, symmetry, mucosal wave, and amplitude changes of both vocal cords before and after treatment. Voice therapy was performed once a week for each patient using the VAT program in a holistic voice therapy approach. The average number of treatments per patient was 6.5. In the MDVP, Jitter, Shimmer, and NHR showed statistically significant decreases (p < .001, p < .01, p < .05). VRP results showed that Hz and semitones in the frequency range improved significantly after treatment (p < .01, p < .05), as did PAS, FVC, and PHOT (p < .01, p < .001). The results for videostroboscopy, functional voice disorder, laryngopharyngeal reflux, and benign vocal fold lesions were normal. Thus, the VAT program was found to be effective in improving the acoustic and aerodynamic aspects of the voice of patients with voice disorders. In future studies, the effect of VAT on the same group of voice disorders should be studied. It is also necessary to investigate subjective voice improvement and objective voice improvement. Furthermore, it is necessary to examine the effects of VAT in professional voice users.