• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.23-27
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• 2005

Background and Objectives : Voice disorders can cause problems in patients with benign vocal cord lesions emotionally, physically, economically and functionally. Neither subjective nor objective voice examinations can evaluate such factors adequately. The Voice Handicap Index (VHI) subjectively evaluates voice disorders in terms of physical, functional, emotional factors and measures the patient's perception of the impact of voice disorder. The purpose of this study is to evaluate the usefulness of VHI in the patients with benign vocal cord lesions. Materials and Method : The authors evaluated 37 patients who experienced laryngeal microsurgery for benign vocal cord lesions from september 2003 to August 2004. The VHI was used to measure the postoperative changes of the patient's perception and acoustic analysis and aerodynamic tests were also done. Statistical analysis was done using paired t-test and Pearson's correlation. Results : The VHI scores showed statistically significant reductions postoperatively. In acoustic analysis, jitter and shimmer had statistically significant reductions after surgery but noise-to-harmonics ratio did not. A statistically significant change in the average MFR and MPT perioperatively was found. The relationship between VHI and acoustic, aerodynamic analysis attained statistical significance. Conclusion : The VHI is a useful assessment tool to monitor the patient's self-perception of voice change after the surgery of benign vocal cord lesions. The VHI measurement, when combined with acoustic and aerodynamic analyses, will be helpful in comparing functional outcomes after voice surgery.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.37-42
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• 2009

The purpose of the present study was to determine the effect of the management program known as vocal function exercise (VFE) on voice quality. Typical VFE was modified and applied to patients with vocal nodules by controlling intensity of voice and relieving the vocal fold to solve hyperfunctional problems in VFE. Eight female subjects aged between 28 and 54 who had been diagnosed with vocal nodules took part in the study. The patients performed VFEs once a week for eight weeks. Vocal function exercises consist of voice hygiene, respiratory training, phonation training, and glide training. The subjects' voices were analyzed pre and post therapy on the aspects of acoustics, maximum phonation time (MPT), GRBAS, and voice handicap index (VHI). As a result, it was found that fundamental frequency ($F_o$) was significant increased, shimmer decreased remarkably and that noise to harmonic ratio (NHR) lowered obviously in the acoustic parameter. In addition, MPT was increased significantly. The scale of GRBAS indicated significant improvement in grade, roughness, and strained voice. VHI indicated significant improvement in an emotional part. In conclusion, VFE was effective in improving voice quality for patients with vocal nodules.

• Proceedings of the KSPS conference
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• 2007.05a
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• pp.292-294
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• 2007

This study was designed to compare the translated patient's subjective rating scales for voice evaluation (Voice Handicap Index; VHI, Voice-Related Quality of Life; V-RQOL, Voice Rating Score; VRS) into Korean, taken from 24 professional voice users diagnosed with organic voice disorders. First, the correlation amongh those scales were observed. Second, the correlation between the patient's subjective rating scales and acoustic measures (Jitter%, Shimmer%, NHR) were examined. Third, those scales were compared by clinician's objective scale (G in GRBAS scale). Results indicated that significant correlations among the patients' subjective rating scales and significant correlations of clinician's rating scale with jitter% and Shimmer%, but not with NHR were observed. In addition, there were significant correlations of G with VHI and VHI-P (one of subscale of VHI). However, none of acoustic measures were correlated with the patient's subjective rating scales.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.5-9
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• 2005

Background and Objectives : Glottal area waveform(GAW) shows the plot of glottal area versus time through the 1 cycle. This study is designed to see how it can be applied to laryngeal patients. Material and Methods : A GAW analysis was peformed on 11 patients before and after surgery and 22 persons without laryngeal problems were recruited for control. Acoustic and aerodynamic analysis with VHI(voice handicap index) evaluation were performed. Results. Significant changes in baseline offset, gross closing rate and VHI were observed postoperatively. Other parameters were changed but insignificant. Conclusion : GAW maybe used to evaluate patient with voice problems.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.102-107
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• 2016

Background and Objectives : Vocal polyps are caused by inflammation induced by stress or irritation. Many patients with vocal polyps complain voice discomfort. For vocal polyps, surgery such as laryngeal microsurgery has been the mainstay of management. We analyzed the clinical features of vocal polyps, and how the size and location of vocal polyps affect the outcomes of surgery. Methods : We retrospectively reviewed 42 patients from March 2014 to December 2015, who were diagnosed as unilateral single vocal polyp. When we operated on a vocal polyp with laryngeal microscopy, we measured their size and location. The quality of voice was evaluated by GRABS scale, jitter, shimmer, NHR (noise to harmonic ratio), MPT (maximum phonation time), and VHI (voice handicap index) before operation and 4 weeks after operation. Results : When we divided the patients into large-sized vocal polyp group (the longest length >3 mm) and small-sized vocal polyp group (the longest length ${\leq}3mm$), all parameter differences tend to be greater at large sized vocal polyp. However, these differences were not statistically significant (p>0.05). When we divided into two groups depending on the volume of vocal polyp, no distinct tendency was found. When we compared the location (anterior, mid and posterior) of vocal polyp with the improvement of voice quality, more change was found at mid portion vocal polyp, except the difference of VHI. However, these differences were also not statistically significant (p>0.05). Conclusion : All parameter differences tend to be greater at large vocal polyp and polyp of the mid location.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.2
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• pp.113-116
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• 2008

Baekgroud and Objectives: The study was purposed to evaluate the relationship between the voice change and the menstrual cycle by measuring the variation of subjective and objective parameters. Materials and Methods: Prospective study of 13 healthy women during 2 mentrual cycles. Their voices were recorded at follicular phase and then luteal phase of the menstrual cycle. We used both single vowel /a/ and sentences for evaluate acoustic parameters. Aerodynamic parameters were also evaluated. Voice handicap index (VHI), and the presence of premenstrual syndromes (PMS) were checked at each period. We used Wilcoxon's signed rank test to compare the parameters of two periods. Results: VHI were 5.1 at both periods (p=0.146) and 92.3% of women were diagnosable with PMS. There were no significant differences in acoustic parameters and aerodynamic parameters between the two periods. Conclusion: This study shows that not only the subjective but also the objective changes of the voice parameters did not exist during the menstrual cycle in women.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.229-234
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• 2018

Background and Objectives : Vocal nodules occur with a 12-22% prevalence in pediatric populations. Most otolaryngologists recommend voice therapy as the primary treatment. The aim of this study is to evaluate patient compliance with voice therapy and its effect on vocal nodules in children. Materials and Methods : We retrospectively reviewed 44 pediatric patients between 3 and 11 years old diagnosed with vocal nodules between March 2015 and December 2017. We evaluated the treatment adoption rate, dropout rate during voice therapy, and reasons for dropout. For patients who completed voice therapy, we measured the changes in nodule size, perceptual parameters, and acoustic parameters. We evaluated patient satisfaction using the pediatric voice handicap index (P-VHI). Results : Of the 44 pediatric patients diagnosed with vocal nodules, 22 (50%) agreed to voice therapy. Of the 22 patients who started voice therapy, 5 (22.7%) dropped out during therapy because they were unsatisfied with their treatment. Another 4 patients discontinued therapy for reasons unrelated to treatment effectiveness. Vocal nodule disappeared or decreased in all 13 patients who completed voice therapy. All voice parameters were improved and statistically significant changes were observed in perceptual, acoustic, and P-VHI parameters. Conclusions : Although compliance to voice therapy among the pediatric patients with vocal nodules was low, there were significant improvements in voice parameters for those who completed voice therapy. A change toward a positive perception of voice therapy is necessary and a multidisciplinary approach is needed to improve the effect of voice therapy on pediatric patients with vocal nodules.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.27-30
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• 2004

Background and Objectives : The purpose of the present study is to investigate the effect of vocal hygiene education for the female elementary school teachers. Materials and Method : Thirty healthy female elementary school teachers were enrolled for the study. We provided a vocal hygiene education to the half of them. Voice handicap index and acoustic parameters were measured before and 4 week after the education. The efficacy of vocal hygiene education was analyzed by Wilcoxon Signed-rank test. Results : The vocal hygiene group showed significant improvement both in the subjective and objective data after the education. However, the non-vocal hygiene group failed to show any improvement. In functional score, emotional score, jitter, shimmer, only Junior Class(JC) could find significant after the education. Only low career(LC) could find significant in subjective data. Conclusion : Vocal hygiene education may be useful in reducing vocal misuse and abuse associated with teaching, and can be an effective method to maintain and improve the vocal health of teachers.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.52-56
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• 2009

Background and Objectives : Vocal nodule is common inflammatory vocal cord lesion which could be improved by voice rest or voice therapy. But some patients, who do not have any improvement after voice therapy, should take laryngomicorsurgery or additional long-term voice therapy. So we try to find prognostic factors which affect the results of voice therapy. Materials and Methods: There are 36 patients (response group) whose symptoms improved after initial voice therapy and 16 patients (no response group) whose symptoms did not improve at all. We compared clinical features (durations of symptoms, voice abuse, laryngopharyngeal reflux), GRBAS scale, acoustic analysis, aerodynamic analysis and voice handicap index between the two groups from January, 2006 to June, 2008. Results: Response group underwent voice therapy 4.5 times (ave.) and no response group underwent 6.7 times (ave.). No response group has longer duration of symptoms, higher GRBAS scale score, higher NIH ratio, and higher MFR than those of response group. Conclusion : This study found that the prognosis of voice therapy in patients who have longer duration of symptoms, high NIH ratio, and bad perceptional test result is not likely to be good. In those cases, we should recommend earlier surgery, voice therapy after surgery, and inform about the necessity of long-term voice rehabilitation or voice therapy in order to get favorable compliance.