알코올 섭취 후 나타나는 음성 변화와 역류성 후두염과의 관계

문고정,김기형,김성태,안철민 대한후두음성언어의학회 2003 대한후두음성언어의학회지 Vol.14 No.2

Background and Objectives : Although many studies have examined the effect of drinking on voice change, its cause and degree remain unclear. Since voice change occurs more frequently the day following drinking, rather than immediately afterwards, we examined whether the voice change was correlated with reflux laryngitis due to gastroesophageal motor disturbances. Subjects and Methods : For this study, 10 patients were selected who had neither voice change nor symptoms of reflux laryngitis at baseline (male : female=5 : 5, mean age=28 years old) They were subjected to psychoacoustic, acoustic, and aerodynamic tests and video stroboscopy at 4:00 P.M. the day before drinking (test 1), at 8:00 A.M. (test 2) and 4:00 P.M. (test 3) on the following day. On the day of drinking, the subjects had to drink more than their usual amount of Soju(Korean liquor) and were not allowed to talk much. The stroboscopy findings were quantified using the PC Belafsky score. Results : The laryngeal response to gastric reflux after drinking was compared between tests 1 and 2. In both tests, laryngeal edema and injection were observed on video stroboscopy. The psychoacoustic test detected more severe hoarseness in test 2 than in test 1. In addition, the acoustic test detected a mild increase in both jitter and shimmer. However, the differences between tests 2 and 3, which were performed when there was reduced or no gastric reflux, were not significant. Conclusions : Drinking may cause gastric reflux, which produces reversible voice change by irritating the vocal cords and larynx. Therefore, reflux laryngitis should be suspected in a patient whose voice changes markedly after drinking.

성대 점막하출혈의 발생 요인에 관한 연구

문고정,정덕희,안철민 대한후두음성언어의학회 2000 대한후두음성언어의학회지 Vol.11 No.2

Background and Objectives : Vocal fold hemorrhage occur by blood accumulation in Reinke's space by vocal trauma. It is mostly asymptomatic, but in some cases it may cause severe dysphonia. It is often seen in patients who use their voice professionally. However, recent changes of life style affected the phonation in general population. We studied to know what are the causes and what are the major factors to affect the vocal fold hemorrhages. Materials and Methods : 19 subjects were evaluated by using of questionaire and laryngoscopic examinations. We evaluated the factors to lead the change in voice directly, underlying causes, occupations and laryngeal findings. Results : The direct causes of the vocal fold hemorrhages were clearing throat, talking, coughing and singing. Reflux laryngitis and upper respiratory infection were the underlying diseases. Vocal fold hemorrhages were developed during the menstruation in 5 patients. Accompanying functional voice disorders were seen in 13 patients, such as, vocal fold nodule, nodule with varix, vocal polyp, Reinke's edema. Patients with reflux laryngitis had the habits of clearing throat as the direct cause of the vocal fold hemorrhages and had hyperkinetic functional voice disorders. Voice abuse was the direct cause of the vocal fold hemorrhages in patients who was in the period of the menstruation. The most common site of the hemorrhage was at the membranous portion of the vocal folds. Conclusions : Authors thought the forceful laryngeal activity was the cause of the vocal fold hemorrhages. And reflux laryngitis and menstruation was the risk factors of the vocal fold hemorrhages.

비기질적 음성질환에서 관찰되는 Videokymography 소견

안철민,문고정,정덕희 대한이비인후과학회 2001 대한이비인후과학회지 두경부외과학 Vol.44 No.10

메니에르병이 의심되는 환자에서 변조이음향방사 잠복기에 관한 연구

이미숙,문고정 한국언어치료학회 2006 한국언어치료학회 학술발표대회 논문집 Vol.2006 No.12

성대구를 동반한 양성성대질환의 진단율 및 발성학적 특징

안철민,문고정,김미라,우원근,김성태 대한이비인후과학회 2003 대한이비인후과학회지 두경부외과학 Vol.46 No.3

비대칭적인 후두운동에 관한 연구

안철민,문고정,정덕희 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.1

Background and Objectives:Voice is produced by the vibration of the vocal fold mucosa and laryngeal movements affect its vibration. It is speculative that asymetric laryngeal movements might be the cause of inadequate vibration of the vocal fold mucosa. Using the pharyngogram, authors studied the relation betwen the asymetric laryngeal movements and laryn-geal nodule in functional voice disorders. :Thirty patients with laryngeal nodule and thirty normal subjects were evaluated. All subjects were evaluated by an acoustic analysis and maximum phonation time. Laryngeal move-ments were investigated with a laryngostroboscopy. And we investigated the asymetric movement of larynx and perilarynx using /i/ phonation pharyngogram. Results:Acoustic analysis and maximum phonation time of the patients with laryngeal nodule were different with that of normal subjects. Asymetry of arytenoid movements and asymetry of thyroid cartilage metry of pyriform sinus was more comon in the patients with laryngeal nodule in the examination of the /i/ phonation pha-ryngogram. Conclusion:Laryngeal asymmetry might affect more commonly the vibration of the vocal fold mucosa in the patients with laryngeal nodule. (Korean J Otolaryngol 2002;45:76-81)

기능성 음성 질환에서 발성 인두조영술의 사용에 관한 연구

안철민,문고정,정덕희 대한후두음성언어의학회 2001 대한후두음성언어의학회지 Vol.12 No.2

Background and Objectives : There are so many methods to investigate the causes of voice disorders. However, they were almost invasive or non-physiologic methods. And none of them showed the laryngeal movements. Phonation pharyngogram is non-invasive method to see the laryngeal movement directly. Authors studied to evaluate the availability of phonation pharyngogram in laryngeal nodule. Materials and Methods : 30 laryngeal nodules and 10 control groups were evaluated. Acoustic analysis and maximum phonation time were measured and pharyngogram was taken during sustaining /a/ phonation immediately after swallowing the barium. We measured the width of hypopharyngeal wall, shape of hypopharyngeal wall and pyriform sinus apex, level difference between both true vocal folds, angle of subglottis, location of true vocal folds, elevated distance of vocal folds and shape of c-spine. Results : Jitter, Shimmer of laryngeal nodule were higher than control group and maximum phonation time was shorter in laryngeal nodule. There was a significance in width of hypopharyngeal wall, shape of pyriform sinus apex, level difference between both true vocal folds, elevated distance of vocal folds and shape of c-spine. Conclusions : Authors knew that there were differences when we used the phonation pharyngogram between normal group and laryngeal nodule group.

후두의 류마티스성 관절염 1예

안철민,문고정,김향초 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.5

Rheumatoid arthritis is a destructive systemic disorder of unknown etiology. The disease follows a prolonged and fluctuating course. It is characterized by periods of remision and exacerbation. Typically articular manifestations are encountered in the laryngeal involvement in the course of disease course. Postmortem studies suggest that the actual incidence of laryngeal arthritis may be as high as 50-80%. Yet the studies of laryngeal arthritis have not been reported in Korea. It is thought that because of the lack of interest in laryngeal arthritis, a lot of diseases caused by laryngits or vocal cord paralysis have been overlooked. Authors report with a review of the literature that a patient who suffered from voice change and cord palsy was confirmed to have laryngeal arthritis. (Korean J Otolaryngol 2002;45:522-5)

성대결절의 위치와 발성 방법과의 관계

안철민,문고정,정덕희 대한후두음성언어의학회 2002 대한후두음성언어의학회지 Vol.13 No.1

Background and Objectives : The vocal fold nodules which were made by excessive contact or vibration of the vocal folds were classified to the soft nodule and the hard nodule in according to the hardness or the duration of nodule. Sometimes laryngologist saw the nodule to be located in different level. Authors thought that each nodule to be located in different level might have the different causes. Therefore we studied to know the relationship between the voicing technique and each vocal fold nodule to be located in different level. Materials and Methods : One-hundred forty nine patients who had the vocal fold nodule were evaluated. Sites and shapes of the vocal fold nodules were investigated using videostroboscopy. Videokymography was also used to scan the center of the vocal fold nodules during phonation and classified to several types. Same procedures were done on normal subject while he simulated the various types of voicing. And we compared the findings between both of them. Three different types of lesion can be distinguished. These are ML group that lesions were located from mid to low, MH group that lesions were located from mid to upper and HL group that lesions were located from lower to upper of the vocal folds. Results : The VKG findings of ML group and situation simulating with hard glottal attack and vocal fry were similar. MH group had a similar VKG findings with situation simulating with whispering or high pitch voicing. HL group had a similar VKG findings with situation simulating with loud voicing. Conclusions : Authors thought that each vocal fold nodule, which had different shapes and located in different level, related with the different types of voicing.

메니에르병 환자에서 변조이음향방사 잠복기에 관한 연구

이미숙,장현숙,문고정,서용규 한국청각언어재활학회 2006 Audiology and Speech Research Vol.2 No.2

이음향방사(Otoacoustic Emission, OAEs)는 신경부위의 정상여부와 상관없이 발생되는 것으로 청신경의 전단계인 와우관의 능동적 활동에 물리적 기전을 제공하는 외유모세포의 반응을 측정하는 것이다. 따라서 외유모세포의 손상을 일찍 감지할 수 있는 민감성으로 이독성 약물이나 소음, 혹은 연령에 따른 와우의 변화 상태를 신속하게 추적관찰할 수 있다.14) 그 중 1979년 Kemp에 의해 측정된 변조이음향방사(DPOAE)는 검사의 비침습성과 짧은 검사시간 안정된 결과 및 재현성으로 임상적 유용성이 점차 확대되고 있다. 특히, 메니에르병에서의 와우 손상 후의 국소적 평가 및 병리적 기전과 관련하여 와우의 기능 평가에 있어 그 유용성의 평가 가치가 높다. Martin 등18)은 메니에르병에서 글리세롤 테스트에서의 삼투압현상에 의해 야기된 개선된 청력 역치를 감지하는 것이 가능하여 와우의 손상 및 변동 평가를