• 대한기관식도과학회지
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• 제9권1호
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• pp.30-38
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• 2003

Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50％ to 70％ of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20％ to 30％ range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

• 말소리와 음성과학
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• 제5권3호
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• pp.95-101
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• 2013

Aging is related to anatomical and physiological changes in respiratory and phonation organs. These changes influence articulation which leads to inaccurate speech and slow articulatory diadochokinesis(DDK). DDK indicates the range, rate, regularity, accuracy, and agility of articulation that reflect motor speech function. The purpose of this study is to investigate the rates and regularities of DDK in healthy Korean elderly through passive acoustic analysis (Praat). Thirty subjects between the ages of 65 and 94 participated in this study. Rate was observed for 5 seconds, while regularity was calculated based on the standard deviation on the following: 1) syllable duration of each task; 2) gap duration between syllables. Then, simple regression analysis was conducted in order to examine the effect of age on performance. The result showed that the slow rate was not a significant factor in terms of advancing age. Furthermore, regularity indicated a significant difference in the following: 1) /pʌ/, /kʌ/ and /pʌtʌkʌ/ in syllable duration; 2) /kʌ/ duration in the gap between syllables. In conclusion, articulatory coordination is reduced with the onset of aging. In particular, /kʌ/ would be a sensitive task for articulatory coordination.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.381-384
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• 2005

Rhabdomyosarcoma is a rare malignancy of head and neck region. When rhabdomyosarcoma occurs in maxillary area, total maxillectomy is necessary. Total maxillectomy causes defects of orbital floor, palate, gingiva, and alveolar bone, causing severe facial deformity and functional impairment. Immediate maxillary reconstruction has to cover both bone and soft tissue to minimize cosmetic and functional problems. The fibular osteocutaneous free flap can provide paranasal, gingiva, oral mucosal lining and foundation for dental prosthesis, thus ensuring good cosmetic results and mastication, phonation function. We have experienced a reconstruction case of a 19-year-old man with rhabdomyosarcoma of the left maxillary sinus. The patient underwent total maxillectomy and neck dissection. We designed a fibular free flap that had a vascularized bone segment and a double skin paddle. Surgical outcomes were excellent in cosmetic and functional aspects.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.64-68
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• 2000

Background and Objectives : To assess the role of altered vocal function in transient voice change after short-term endotracheal intubation, we evaluated acoustic parameters, aerodynamic parameters, and laryngoscopic characteristics preoperatively and postoperatively. Materials and Methods : Vocal function of 10 patients undergoing tympanoplasty and mastoidectomy using general anesthesia and endotracheal intubation were studied preoperatively, at 1day and 7 days after extubation. Acoustic analysis, aerodynamic study, and telescopic examination were used to assess vocal function. Results : In acoustic parameters, there was no significant difference between preoperative and postoperative measures. However, in subglottic pressure, ere was a significant decrease at 1 day after extubation and this change was return to preoperative value at 7 days after extubation. MPT(Maximal Phonation Time), MER(Mean flow Ratio), and VC(Vital Capacity) were decreased 1 day after extubation but did not show statistically significant change. Three of 10 patients manifested a vocal fold edema and injection 1 day after extubation. Conclusions : Subglottic pressure revealed a significant decrease at 1 day after extubation. And this change was correlated with laryngeal morphologic change and decrement in pulmonary function.

• 대한후두음성언어의학회지
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• 제9권2호
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• pp.128-133
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• 1998

Background and Objectives : Despite of numerous treatment modalities for glottic insufficiency, it still remains unresolved problem. Recently, autologous collagen injection was introduced as a new treatment for glottic insufficiency. This study was attempted to evaluate the efficacy of this treatment modality. Materials and Methods : Ten patients diagnosed as symptomatic sulcus vocalis with glottic insufficiency and agreed with this procedure were selected. Injectable collagen was obtained from the patient's dermis. It was injected into the pathologic area of the vocal fold. After injection, 4 of 10 patients were 1311owe4 up more than 5 months, and their voice were evaluated prior to injection and at 5 months after injection, using subjective, perceptual, aerodynamic, acoustic and videostroboscopic assessments. Results : In the aerodynamic assessment, 2 of 4(50%) patients was improved in MFR(mean flow rate), but no change was noted in MPT(maximum phonation time). In the acoustic assessment, no definite improvement was noted. In the subjective and perceptual assessments, 2 of 4(50%) patients was improved. In the videostroboscopic assessment, chink was reduced but still remained. Serious complication was not noted. Conclusion : Autologous collagen injection was reported as ideal treatment for glottic insufficiency, but our results were relatively unsatisfactory. But considering that our study is preliminary, it is too hasty to determine the efficacy of autologous collagen injection. We think that further study is required.

• 수산해양교육연구
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• 제28권3호
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• pp.818-830
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• 2016

The purpose of this study is to examine the effects of the parents listening guidance program, which allows the parents to understand their hearing impaired children and how to listen at home, on the communication skills of the hearing impaired children. The research subjects were 3 hearing impaired children who did not accompany with the intellectual, emotional and behabioral problems, and the listening guidance has been performed for their parents for 3 months through the listening guidance program. The changes in the communication skills in the hearing impaired children were observed comparing before and after the education. In the results, first, the receptive language skill of the hearing impaired children was improved after than before the parents listening guidance. Second, the expressive language skill of the hearing impaired children was improved after than before the parents listening guidance, too. Third, in the communication behavior of the hearing impaired children, the phonation and the speech production were increased together with the gesture after the parents listening guidance. In conclusion, it is deemed that the parents listening guidance program would have positive influence on the communication behavior of the hearing impaired children.

• 말소리와 음성과학
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• 제9권4호
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• pp.99-106
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• 2017

Clinical data about vocal nodules have seldom been reported, even though vocal nodules are commonly diagnosed in outpatient speech and voice clinic. This study aims to investigate clinical characteristics of the patients who are diagnosed with vocal nodules. This study analyzed the data for 10 years from the 319 patients diagnosed with vocal nodules (45 males and 274 females with the mean age of 39.4 ranging from 2 to 83) in terms of gender, age, occupation, voice change initiation pattern, change with time, throat clearing, smoking history, type of voice abuse, acoustic analysis, maximum phonation time, GRBAS, and VHI. Thirteen patients (4.08%) had unilateral vocal nodule and 306 patients (95.9%) had bilateral vocal nodule, the majority of which had a pattern of asymmetry (73.9%). The glottal closure pattern was hourglass in 72.1% of patients, posterior chink in 17.9% of patients, and irregular in 7.9% of patients. The most common occupational category was professional voice users (43.4%). The voice abuse pattern included excessive talking in 96 patients (76.8%), loud voice in 78 (62.4%) patients, and excessive singing in 17 patients (21.6%). The patients showed worse scores in G, B, and S than in R and A for the GRBAS evaluation. The most recommended treatment for vocal nodules was voice therapy. The current clinical data will be helpful for treatment planning for the patients of vocal nodule.

• 음성과학
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• 제15권4호
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• pp.159-170
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• 2008

The purpose of this study was to find out the ability of coordination of the articulatory motor and the ability of control of the respiration and laryngeal for spastic dysarthria by acoustic analysis. The sustained of vowel /a/ and repetition of syllable /pa/ in 15 normal and 10 spastic dysarthria were measured. Multi-Speech, MDVP, and MSP were used for data recording and analysis. As a result, the mean DDK rate in the spastic group was significantly slower than in the normal. The maximum phonation time in the spastic group ($4.80{\pm}1.94$) was shorter than in the normal ($11.20{\pm}3.72$). The DDKjit in the spastic group was significantly higher than in the normal. The DDKsla was reduced in the spastic group. The mean syllable duration in the spastic group (146.2ms) was significantly longer than in the normal (75.8ms). The mean energy was reduced in the spastic group. The range of Fo was greater than in the normal. The frequency perturbation (jitter, vFo) and amplitude perturbation (shimmer, vAm) were higher than in the normal group. The NHR was higher than in the normal group. The parameters of this were significantly difference between the spastic dysarthria and the normal (p<0.05). Finally, the spastic dysarthria has short respiration, slow speech rate, and voice quality problem. The these results will help to establish a plan and the intervention of treatment.

• 말소리와 음성과학
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• 제4권4호
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• pp.155-162
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• 2012

The population of Korea is ageing as the number of elderly people increases due to improvements in health care and diet. Accordingly, it is expected that interest in how to live actively during the years after retirement and how to communicate effectively will increase the demand for voice improvement methods and technology. However, the criteria to evaluate the voice strength and characteristics of the elderly are lacking. In this study, we analyzed the acoustic characteristics of elderly women living in the community according to residential status and mental health status (e.g. depressive mood). Accordingly, we selected women (n=63) above the age of 65 age who were living in the Seoul metropolitan area and Daegu Gyeongbuk. The selected subjects were divided into two groups: a normal speaker group (n=40) and a speaker group comprised of those suffering from depressive mood (n=23). This study analyzed the voice characteristics of subjects based on collected data through the sustained phonation of the vowel /a/. It was shown that there were differences among MPT, F0, Jitter, Shimmer and NHR depending on location of residence but no difference with regard to depressive mood. Therefore, we must consider location of residence in elderly as the key factor in demonstrating the voice norms of seniors.

• 말소리와 음성과학
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• 제4권4호
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• pp.147-154
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• 2012

The purpose of this study is to examine the effect of voice improvement when vocal training, which relaxes the vocal contact, is applied to children with vocal nodules. Subjects included 20 5- to 12-year-old boys with vocal nodules in Otolaryngology and for whom voice therapy had been advised. The vocal therapy was conducted for 40 minutes per a week for a total of eight times. Results were evaluated by videostroboscopy, auditory-perceptual evaluation of GRBAS Scale, aerodynamic test, and acoustic analysis before and after therapy. As a result, first, the size of vocal nodules was reduced and the unstable pattern of vocal contact was improved. Glottic closure was increased and Phase symmetry was decreased during vocal vibration. Mucosal wave was increased and muscle tension of the larynx was reduced. Second, auditory-perceptual evaluation showed that subjects' overall quality of voice improved. GRBAS Scale Evaluation showed that the characteristics of the subjects' voice which were rough, breathy, and strained and breathy were reduced after therapy. Third, the measurements of acoustic parameters showed a statistically significant improvement. The fundamental frequency of the subejects' voice was increased and values of Jitter and Shimmer, NHR, [H1-H2] decreased. Fourth, the maximum phonation time of children was increased. These results imply that vocal relaxation training conducted in this study has a very positive effect to improve the voice of children with vocal nodules.