속삭임과 발성의 공기역학적 비교

서인효,성철재,황영진 한국언어치료학회 2012 한국언어치료학회 학술발표대회 논문집 Vol.2012 No.12

성대 양성점막 질환에서 수술 전후 음질변화를 객관적으로 반영하는 음향지표 분석

서인효,정동식,한현주,문정환,정필상,이상준 대한이비인후과학회 2016 대한이비인후과학회지 두경부외과학 Vol.59 No.11

Background and Objectives The aim of this study was to compare between preoperative and postoperative voices by subjective auditory perceptual evaluation and objective acoustic analysis. The study also analyzed the acoustic parameters that best reflected the auditory perceptual characteristics in laryngeal microsurgery. Subjects and Method The records of 49 patients who had been diagnosed as benign vocal fold mucosal diseases and had undergone laryngeal microsurgery were retrospectively analyzed. Preoperative and postoperative voices were assessed by auditory perceptual evaluation using the GRBAS Scale and acoustic analysis using Multi-Dimensional Voice Program (MDVP) and Analysis of Dysphonia in Speech and Voice (ADSV). Correlation between auditory perceptual characteristics and acoustic parameters was analyzed. Results Auditory perceptual evaluation showed that the patients’ voices were improved after the operation. Several acoustic parameters of MDVP related to short-term and long-term variability showed significant improvement. Also, there were significant differences in several cepstral/spectral parameters of ADSV after operation. In the correlation analysis, the overall grade (G) of the GRBAS Scale showed highest correlation with the cepstral spectral index of dysphonia (CSID) (r=-0.700). The roughness (R) of GRBAS Scale was correlated with the smoothed amplitude perturbation quotient of long-term variability of MDVP (r=0.468), breathiness (B) with cepstral peak prominence (r=-0.703) and strain (S) with CSID (r=0.650) (p<0.01). Conclusion Our results showed that the acoustic parameters were related to the long-term variability of MDVP, and the parameters of cepstrum/spectrum were useful for the objective assessment of voice quality in patients who received laryngeal microsurgery. These parameters were also useful for the quantification of voice quality and abnormality of phonation. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(11):775-9

후두미세수술에서 술 후 음성치료의 역할 및 효과

서인효,문정환,정필상,이상준 대한이비인후과학회 2018 대한이비인후과학회지 두경부외과학 Vol.61 No.4

Background and Objectives Voice therapy is performed following laryngeal microsurgery to help the recovery of the operation site and assist in optimal voice output. The aim of this study was to evaluate the effect of postoperative voice therapy and to obtain objective evidence about the necessity of voice therapy. Subjects and Method The voice of 109 patients who underwent laryngeal microsurgery for vocal fold lesions and received voice therapy was analyzed. Voice analysis was performed preoperatively, postoperatively, and after the first voice therapy. GRBAS scale was used for auditory perceptual evaluation and acoustic analysis was performed for objective evaluation. Results Overall, significant improvement was observed postoperatively in both auditory perceptual evaluation and acoustic parameters, and significantly better voice was obtained after the first postoperative voice therapy. The degree of postoperative voice improvement varied on the type of vocal fold lesions, but voice quality was improved in all diseases after first postoperative voice therapy. The number of voice therapy decreased significantly as the voice quality improved after the operation or the first voice therapy. Four or more voice therapy were needed when the cepstral/spectral index of dysphonia (CSID) value was 5.88 or higher. Conclusion Voice therapy following laryngeal microsurgery was effective in better voice output. The CSID value after the first postoperative voice therapy was predictive of finding patients who need long-term voice therapy. These results suggest that the first postoperative voice therapy will be helpful in finding the adequate vocalization method and providing objective evidence for selecting patients who would require continuous voice therapy.

운동학습이론에 기초한 발성운동조절법이 근오용성 발성장애의 음성에 미치는 효과

서인효(Seo,Inhyo ),이옥분(Lee,Okbun),이상준(Lee,Sangjoon),정필상(Chung,Philsang) 한국음성학회 2011 말소리와 음성과학 Vol.3 No.3

Muscle misuse dysphonia (MMD) is defined as a behavioral voice disorder resulting from inappropriate contractions of intrinsic and/or extrinsic laryngeal muscles. The purpose of this study was to investigate the effect of motor learning guided laryngeal motor control therapy (MLG-LMCT) which is designed to improve an existing LMT and further the effective voice treatment on people with muscle misuse dysphonia. Forty-six people with MMD (MF=16:30) participated in this study. The voice samples of the participants were recorded to investigate the effect of MLG-LMCT before and after the voice therapy. Voice samples were analyzed via electro-glotto-graph (EGG). Contact quotient (CQ), speed quotient (SQ), and waveform were reported. In addition, perceptual and acoustical evaluation were conducted to determine the change of voice improvement after treatment. The experimenter massaged the tensioned muscles around the neck. In order to find more proper phonation the experimenter showed the subjects their EGG wave forms as to whether or not they are moving the vocal folds to the appropriate position. Therefore, the EGG wave forms were used as a type of visual feedback. With the wave form, the experimenter helped subjects move the vocal folds and laryngeal muscles to find more proper voice production. The sensory stimuli from the experimenter gradually faded out. A paired dependent t- test revealed that there was significant differences in CQ between pre- and post-therapy. Perceptually, overall, rough, breathy, strain, and transition were significantly reduced. Acoustically, there were significant differences in Fo, jitter, shimmer, and NHR. After using MLG-LMCT, most of the subjects showed improvements in voice quality. The results from this study led us to the following conclusions: Motor learning guided laryngeal motor control therapy (MLG-LMCT) has reduces muscle misuse dysphonia. These results may occur because a visual feedback from EGG wave form can maintain the effect of the muscle tension reduction from laryngeal manual therapy. In case of people with MMD who reduced muscle tension from the therapy (LMT) but, not appropriately manipulating the location of larynx or adducting the vocal folds, MLG-LMCT might be an alternative therapy approach.

마비말화자와 정상화자의 양자택일의문문 운율비교

서인효(In Hyo Seo),성철재(Cheol Jae Seong) 한국언어청각임상학회 2012 Communication Sciences and Disorders Vol.17 No.3

배경 및 목적: 본 연구는 양자택일의문문 억양모방과제의 분석을 통하여 정상화자와 마비말화자의 운율특성을 말속도와 억양기울기를 중심으로 비교하여 보았다. 방법: 연구대상자는 남자 성인 29명으로 마비말화자 16명, 정상화자 13명이었다. 결과: 마비말화자는 정상에 비해 말속도와 조음속도가 느렸다. 발화시간과 조음시간은 더 길었으나, 쉼시간과 쉼비율은 유의한 차이를 보이지 않았다. 문장전체의 억양기울기는 기본주파수기울기와 4분음기울기가 정상화자처럼 하강하였으나 그 정도는 완만했고, 절대차 평균기울기는 유의한 차이를 보이지 않았다. 두 번째 의문문미구의 기본주파수기울기와 4분음기울기의 하강정도, 절대차 평균기울기는 유의한 차이를 보이지 않았다. 반면, 첫 번째 의문문미구의 기본주파수기울기와 4분음기울기의 상승정도, 절대차 평균기울기는 완만했다. 논의 및 결론: 본 연구결과는 마비말화자는 일반적으로 말속도가 느리고, 억양은 전반적으로 완만하며, 특히 상승억양에서 완만함이 두드러짐을 보여준다. Background and Objectives: The present study reports on the nature of the prosodic disturbances in subjects with dysarthria compared with normal speakers. Methods: This study, based on analysis of intonation stimulability for alternative question sentence, reports on temporal and intonational components for 16 subjects with dysarthria and 13 healthy controls. Results: Prosodic features that were preserved in the subjects with dysarthria were pause proportion, ㎃ slope for sentence and all of intonation slope in sentential Q2 final word. However, the subjects with dysarthria had reduced speaking and articulation rates, reduced F₀ slope and q-tone slope for sentence, and all of intonation slope in sentential Q1 final word. Discussion and Conclusion: The results showed that specifically, in rising intonation, subjects with dysarthria had slower speech rate and more gradual intonation slope than normal speakers.

연결발화에서 마비말화자의 음질 특성

서인효(Seo, Inhyo),성철재(Seong, Cheoljae) 한국음성학회 2013 말소리와 음성과학 Vol.5 No.4

This study investigated the perceptual and cepstral/spectral characteristics of phonation and their relationships in dysarthria in connected speech. Twenty-two participants were divided into two groups; the eleven dysarthric speakers were paired with matching age and gender healthy control participants. A perceptual evaluation was performed by three speech pathologists using the GRBAS scale to measure the cepstrual/spectral characteristics of phonation between the two groups’ connected speech. Correlations showed dysarthric speakers scored significantly worse (with a higher rating) with severities in G (overall dysphonia grade), B (breathiness), and S (strain), while the smoothed prominence of the cepstral peak (CPPs) was significantly lower. The CPPs were significantly correlated with the perceptual ratings, including G, B, and S. The utility of CPPs is supported by its high relationship with perceptually rated dysphonia severity in dysarthric speakers. The receiver operating characteristic (ROC) analysis showed that the threshold of 5.08 dB for the CPPs achieved a good classification for dysarthria, with 63.6% sensitivity and the perfect specificity (100%). Those results indicate the CPPs reliably distinguished between healthy controls and dysarthric speakers. However, the CPP frequency (CPP F0) and low-high spectral ratio (L/H ratio) were not significantly different between the two groups.

정상성인 화자의 속삭임성에 대한 켑스트럼 및 스펙트럼 분석

서인효(In Hyo Seo),이옥분(Ok Bun Lee) 한국언어치료학회 2015 言語治療硏究 Vol.24 No.4

Purpose: This study was performed to compare the cepstral/spectral multiparameters of whispery voice and modal voice in healthy adults and to evaluate the cepstral/spectral analysis for assisting the objective discrimination of whispery voice and modal voice. Methods: Eleven typical adults without voice and communication problems participated in this study. Two speech pathologists with professionality in voice and speech analysis judged perceptually of whispery voice and modal voice in the healthy adults. In addition, the acoustic analysis of cepstral/spectral analysis (CPP, CSID, L/Hratio, CPPF0) were performed for the same voice samples (e.g., sustained vowel /ah/). Results: In auditory-perceptual judgement of whispery voice in healthy adults, the overall dysphonic grade (G) was 1.27 (mild to moderate) and strain (S) was comparable to breathy (B). In whispery voice, lower cepstral peak prominence (CPP, p < .01) and higher cepstral and spectral index of dysphonia (CSID, p <. 01) appeared. The CPP frequency (CPPF0) and ratio of low to high-frequency spectral energy (L/Hratio) was not significantly different between whispery voice and modal voice. ROC analysis showed that the threshold of 9.05dB for CPP or 2.05 for CSID achieved an excellent classification for whispery voice, with perfect sensitivity (100%) and specificity (100%). Conclusions: These results indicated that CPP and CSID reliably distinguished whispery voice and modal voice. However, furhter study in the multidisciplinary aspects in required to define incomplete vocal closure and glottic/supraglottic hyperfunction of whispery voice depending on various phonation conditions.

병리적 속삭임과 발성의 공기역학적 비교

서인효(Seo, Inhyo),황영진(Hwang, Youngjin),성철재(Seong, Cheoljae) 한국음성학회 2013 말소리와 음성과학 Vol.5 No.1

This study compared the aerodynamic multiparameters of whispers and phonation in patients with muscle misuse dysphonia(MMD) to evaluate the voice aerodynamic analysis for discrimination between whispers and phonation. Eleven patients with muscle misuse dysphonia were examined. Whispers were shorter with a maximum phonation time(MPT; p<.01), a lower phonatory sound pressure level(SPLp; p<.01), a higher phonatory flow rate (PFR; p<01), lower phonatory efficiency(PE; p<.01), and a lower phonatory resistance (PR; p<.05) than phonation. The subglottal pressure level was not significantly different between whispers and phonation. (Psub; p>.05). The ROC analysis showed that the threshold of 23.83 ppm for PE achieved a good classification for whispers, with the perfect sensitivity(100%) and specificity(100%). Those results indicate PE reliably distinguished between whispers and phonation. The results also suggest that PE may provide a useful tool for studying the laryngeal source.

전체성 실어증자의 의사소통 양식별 잔존 능력 정도에 따른 중재 효과 비교

서인효(In-Hyo Seo),권도하(Do-Ha Kwon) 한국언어치료학회 2000 言語治療硏究 Vol.9 No.1

편측 하악전달마취가 운동구어능력에 미치는 영향

양승재,서인효,김미은,김기석,Yang, Seung-Jae,Seo, In-Hyo,Kim, Mee-Eun,Kim, Ki-Suk 대한안면통증구강내과학회 2006 Journal of Oral Medicine and Pain Vol.31 No.1

There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.