후뒤세수술에서 미세피판술의 원칙

권택균,손희영,Kwon, Tack-Kyun,Son, Hee-Young 대한후두음성언어의학회 2010 대한후두음성언어의학회지 Vol.21 No.2

The vibratory or phonating surface of the human vocal folds is a complex layered structure. Benign vocal fold lesions arise primarily within the lamina propria of the vocal folds and produce dysphonia by disrupting the normal layered architecture of the phonating surface. Therefore, treatment is aimed at excision of the lesion with restoration of the normal layered architecture. The core principle of the Microflap approach is that conservative removal of submucosal pathology with preservation of overlying normal epithelium and superficial lamina propria. Microflap approach is an essential component of most phnomicrosurgical procedures and is a challenging surgical task that requires patience, appropriate instrumentation, surgical skill, and experience. The authors reviewed surgical principles of Microflap technique, instrumentation and surgical tips that could be useful for the beginners who tried to try Microflap technique for the treatment of benign vocal fold mucosal lesions.

후두운동장애

권택균,손희영,Kwon, Tack-Kyun,Son, Hee-Young 대한후두음성언어의학회 2010 대한후두음성언어의학회지 Vol.21 No.1

Neuromuscular Disorders Affecting the Larynx are steadily important topics at laryngology. Physiology of larynx is controlled by the frame structure and neuromuscular dynamics to acting on the specialized soft tissue, Therefore, for a proper understanding of the larynx, it is needed the voice and swallowing, a series of prayers on the regulation of neurologic function and the correlation between systemic neuromuscular disease and laryngeal symptoms and clinical knowledge, We described that clinical findings and treatments of the 3 neurological diseases causing dysphonia well (Parkinson's disease, laryngeal tremor, spasmodic dysphonia) and vocal impairments for stoke patients.

노인성 음성의 치료

권택균,Kwon, Tack-Kyun 대한후두음성언어의학회 2014 대한후두음성언어의학회지 Vol.25 No.1

Presbyphonia is defined as voice change caused by aging. Since presbyphonia is one of the natural aging processes, the treatment should be considered for the patients complaining communication difficulties. The treatment should not only target on presbylaryngis, but also on underlying systemic conditions such as lung function, neurological diseases and medications. Therefore, the treatment for the patients with presbyphonia should be multidisciplinary including underlying disease control, voice therapy and surgical treatment. Although various experiments on treatment of presbylaryngis are currently being tried, repeated injection laryngoplasty is still playing an important role because presbyphonia is destined to get worse over time.

양성 성대 질환의 병태생리에 관한 최신지견

권택균,김민수,Kwon, Tack-Kyun,Kim, Min-Su 대한후두음성언어의학회 2015 대한후두음성언어의학회지 Vol.26 No.2

Substantial confusion exists regarding the nomenclature of benign vocal fold lesions (BVFL), because there were no pathologically diagnostic findings and deep understanding of pathogenesis in the past. There is no consensus on specific labels for BVFL, nor are the most commonly used terms defined. There is a need for a defined nomenclature for the purpose of improving communication among clinicians and with patients. Furthermore, precise definitions of BVFL will facilitate clinical research of voice disorders and may lead to a better understanding of outcomes for BVFL treatment. Laryngoscope, stroboscope, voice evaluation are used to diagnose BVFL. The objective of this review article was to develop a new paradigm of BVFL nomenclature using patient's history, stroboscope, voice therapy results, and operative findings. Furthermore, precise definitions of BVFL will facilitate clinical research of voice disorders and may lead to a better understanding of outcomes for BVFL treatment.

공기 역학 검사

권택균,임윤성,Kwon, Tack-Kyun,Lim, Yun-Sung 대한후두음성언어의학회 2008 대한후두음성언어의학회지 Vol.19 No.2

Several parameters are used for the assessment of phonatory function and voice quality in clinical settings. Glottic airflow, subglottal pressure, mean phonation time, laryngeal resistance and voice efficiency are the most commonly used aerodynamic parameters. Aerodynamic analysis is developed to evaluate phonatory energy source and to estimate laryngeal efficiency. Also these measurements have shown the good correlation with perceptions of breathiness and findings of glottic competence. Aerodynamic study is important to understand relationships between pulmonary and phonatory function.

지연성 성대 마비를 동반한 미주신경에 국한된 Herpes 감염

권택균,Kwon, Tack-Kyun 대한후두음성언어의학회 2005 대한후두음성언어의학회지 Vol.16 No.1

Vagus nerve palsy caused by herpes virus infection is rare. Here, the author presents a 65-year-old woman with acute onset of right side otalgia and sore throat, followed by delayed vocal fold paralysis on the same side. Vesicles were also found on the posterior wall of ear canal but the tympanic membrane was not involved. Laryngoscopy revealed multiple ulcerative lesions on the pharyngeal and laryngeal mucosa exclusively on the right side. One month later, she noticed dyshonia which turned out right vocal fold paralysis. Skull base to upper chest CT did not reveal local lesion. Three months after finishing the acyclovir, her symptoms were almost gone and vocal fold movement has almost completely improved. Vagus nerve involvement of herpes infection should be considered as a differential diagnosis for patients with herpes zoster oticus with sore throat.

두경부수술에서 경동맥 희생과 사전검사

권택균(Tack Kyun Kwon),성명훈(Myung Whun Sung),김광현(Kwang Hyun Kim),김정준,이철희(Chul Hee Lee),민양기(Yang Gi Min) 대한두경부종양학회 1998 대한두경부 종양학회지 Vol.14 No.2

Objectives: The authors tried to analyze the results of carotid artery sacrifice with or without preoperative carotid evaluation. Materials and Methods: Thirteen patients undergone carotid sacrifice were evaluated. Carotid balloon occlusion test (BOT) and single-photon emission computed tomography (SPECT) with technetium-99m-labeled hexamethylpropyleneamineoxime (99mTc-HMPAO ) were used for preoperative carotid evaluation. Results: The causes of carotid artery sacrifice consisted of the neck mass involving the carotid artery, spontaneous aneurysmal rupture, and traumatic pseudoaneurysm. Five patient had postoperative neurologic complications and two of them had permanent neurologic deficits. Conclusion: The authors stress that the preoperative evaluation in carotid artery sacrifice is imperable, and the BOT with SPECT can be used in selecting the method of treatment. But since these tests cannot predict the postoperative outcome perfectly, careful perioperative care of the patients should be exercised regardless of the results of the preoperative evaluation.

음성신호와 전기성문파를 이용하는 새로운 매개변수 ; 성대 폐쇄 지연비율(Glottal Closure Delay Ratio)

최종민,권택균,정은정,이명철,김광현,성명훈,박광석,Choi, Jong-Min,Kwon, Tack-Kyun,Jung, Eun-Jung,Lee, Myung-Chul,Kim, Kwang-Hyun,Sung, Myung-Whun,Park, Kwang-Suk 대한후두음성언어의학회 2007 대한후두음성언어의학회지 Vol.18 No.1

Background and Objectives: Biomedical signals have been usually used for the diagnosis of the laryngeal function such as speech, electroglottograph(EGG), airflow and other signals. But, in most cases these signals were analysed separately. Here, we propose a new interchannel parameter Glottal Closure Delay Ratio(GCDR) which is estimated from speech and EGG measured simultaneously. Materials and Method: Speech and EGG signal were recorded simultaneously from 13 normal subjects, 39 patients. The patients' data included 16 polyps and 23 vocal folds palsy. Time difference between glottal closing instance on EGG and the first maximum peak on speech in a pitch period was calculated. Glottal closing instance was defined as the maximum peak on the first derivative of EGG signal(dEGG). Results: The standard deviation and jitter were calculated using 20-30 GCDRs extracted from each data, and they are significant different between normal and vocal fold paralysis group. Conclusion: The GCDR may be the first index reflecting speech and EGG characteristics and the perturbation of this parameter was significant different between normal and vocal fold paralysis group.

모의 음성 모델을 이용한 효과적인 구개인두부전증 환자 음성 인식

성미영,권택균,성명훈,김우일,Sung, Mee Young,Kwon, Tack-Kyun,Sung, Myung-Whun,Kim, Wooil 한국정보통신학회 2015 한국정보통신학회논문지 Vol.19 No.5

본 논문에서는 VPI 환자 음성을 정상인 음성으로 복원하기 위한 기술의 단계로서 효과적인 VPI 음성 인식 기술을 소개한다. 소량의 VPI 환자 음성을 모델 적응에 효과적으로 사용하기 위해 정상인의 모의 음성을 이용하여 화자 적응을 위한 사전 모델로 이용하는 기법을 제안한다. MLLR 기법을 이용한 화자 적응을 통해 평균 83.60%의 인식률을 보이고, 모의 음성 모델을 화자 적응의 사전 모델로 이용함으로써 평균 6.38%의 인식률 향상을 가져온다. 음소 인식 평가 결과는 제안한 화자 적응 방식이 대폭적인 음성 인식 성능 향상을 가져오는 것을 증명한다. 이러한 결과는 본 논문에서 제안하는 모의 음성 모델을 이용한 화자 적응 기법이 대량의 VPI 환자 음성을 취득하기 어려운 조건에서 보다 향상된 성능의 VPI 환자 음성 인식기를 구축하는데 효과적임을 입증한다. This paper presents an effective recognition method of VPI patient's speech for a VPI speech reconstruction system. Speaker adaptation technique is employed to improve VPI speech recognition. This paper proposes to use simulated speech for generating an initial model for speaker adaptation, in order to effectively utilize the small size of VPI speech for model adaptation. We obtain 83.60% in average word accuracy by applying MLLR for speaker adaptation. The proposed speaker adaptation method using simulated speech model brings 6.38% improvement in average accuracy. The experimental results demonstrate that the proposed speaker adaptation method is highly effective for developing recognition system of VPI speech which is not suitable for constructing large-size speech database.

구개인두부전증 환자와 모의 음성의 모음과 자음 분석

성미영,김희진,권택균,성명훈,김우일,Sung, Mee Young,Kim, Heejin,Kwon, Tack-Kyun,Sung, Myung-Whun,Kim, Wooil 한국정보통신학회 2014 한국정보통신학회논문지 Vol.18 No.7

본 논문에서는 구개인두부전증 (VPI) 환자 발음과 정상인의 모의 발음에 대한 듣기 평가와 음향 분석을 실시한다. 본 연구를 위해 음성 데이터 수집을 위해 50개의 단어, 모음 및 단음절로 이루어진 발음 목록을 설정한다. 듣기 평가실험의 편의를 위해 웹 기반의 듣기 평가 시스템을 구축한다. 듣기 평가 결과는 실제 VPI 환자의 발음에 대한 오인식 경향과 모의 발음의 오인식 경향이 유사함을 나타낸다. 이러한 유사성은 모음의 포먼트 위치와 자음의 스펙트럼의 비교를 통해서도 확인할 수 있다. 실험 결과는 본 연구에서 사용한 정상인의 VPI 모의 발화 기법이 실제 환자의 음성을 비교적 효과적으로 모의하는 것을 반영하는 결과이다. 향후 VPI 환자의 음성 인식 과정에서 정상인의 모의 발화음성 데이터를 음향 모델의 적응 기법과 같은 분야에 유용하게 사용할 수 있을 것으로 기대한다. This paper focuses on listening test and acoustic analysis of patients' speech with velopharyngeal insufficiency (VPI) and normal speakers' simulation speech. In this research, a set consisting of 50-words, vowels and single syllables is determined for speech database construction. A web-based listening evaluation system is developed for a convenient/automated evaluation procedure. The analysis results show the trend of incorrect recognition for VPI speech and the one for simulation speech are similar. Such similarity is also confirmed by comparing the formant locations of vowel and spectrum of consonant sounds. These results show that the simulation method for VPI speech is effective at generating the speech signals similar to actual VPI patient's speech. It is expected that the simulation speech data can be effectively employed for our future work such as acoustic model adaptation.