GRBAS 음성평가와 음성장애지수

손진호,Sohn, Jin-Ho 대한후두음성언어의학회 2008 대한후두음성언어의학회지 Vol.19 No.2

Subjective voice evaluation is necessary and important to assess the voice disorders in addition to objective voice evaluation. Subjective voice evaluation is divided into examiner and examinee subjective voice assessment. The examiner assessment represents perceptual judgment to the patient's voice such as GRBAS scale, Buffalo voice profile, consensus auditory perceptual evaluation of voice (CAPE- V) and so on. The examinee assessment consists of indirect method including voice handicap index (VHI), voice outcome survey (VOS), voice symptom scale (VoiSS), voice related quality of life (V-ROQL) and direct method which is called patient's self-subjective voice rating. This review article describes a general rule, advantages and pitfalls about GRBAS scale, VHI and patient's self-subjective voice rating which are presently most representative voice assessment tools. 주관적 음성평가는 음향분석기기를 이용한 객관적 음성 평가와 함께 음성분석에 유용하고 의미있는 평가방법이며 현재 알려진 검시법정 중에서 GRBAS 음성평가, VHI, patient self-perceptual voice rating이 가장 널리 사용되고 있고 인정받는 방법이다. 주관적 음성평가는 음성의 상태를 모두 대변할 수은 없으며 객관적인 음성평가에 대한 보완적인 의미를 가진다. 현재 개발되어 있는 주관적 음성평가 방법들이 유용한 평가도구이긴 하지만 나름대로의 문제점과 제한점을 가지고 있기 때문에 이에 대한 개선과 보완을 위한 지속적인 연구와 개발이 요구된다.

기능성 음성장애의 병태생리

진성민,Jin, Sung Min 대한후두음성언어의학회 2014 대한후두음성언어의학회지 Vol.25 No.2

기능성 음성장애는 후두에 구조적 혹은 신경학적 병변이 없이 음성발성에 장애가 있는 질환으로, 의학적인 부분만으로 설명하기가 어려운 장애 요소들을 내포하고 있기 때문에 진단에 많은 혼란이 있을 수 있는 논쟁의 여지가 많은 음성질환이다. 기능성 음성장애의 중요한 부분 중의 하나인 muscle tension dysphonia는 후두 근육과 후두 주변 근육의 지나친 긴장에 의해서 발생하는 음성장애로, 비록 후두 내/외근의 운동이 제대로 조절되지 않는 것이 muscle tension dysphonia의 가장 첫 번째 원인이라고 알려져 있고, 특정의 개인적인 인성의 특징(personality traits)들도 발생에 있어서 상당히 중요한 부분을 차지 하는 것으로 연구되고 있지만, 이들 근육이 도대체 어떻게 문제가 되는 지에 대해서는 사실 아직까지 완전하게 설명하기에는 곤란한 점이 많다. 또한 최근 들어서는 muscle tension dysphonia를 하나의 질환으로 보기보다는 기능성 음성장애의 문제점들을 설명하는 진단적 지표(diagnostic label)로 보는 경향이 많으며, 기능성 음성장애와 기질적 음성장애(organic voice disorder)를 아우르는 위치에 있는 것으로 해석하는 경향도 있다. 따라서 기능성 음성장애에 대한 분류나 발생기전에 대한 의견들은 아직까지 논란이 되는 부분들이 많은 상태이고, 기능성 음성장애를 더 잘 이해하고 이 질환을 성공적으로 치료해 나갈 수 있는 중요한 요인들을 찾아낼 수 있도록 더 많은 연구들이 이루어 져야 할 것으로 생각된다. Functional dysphonia refers to a voice disturbance that occurs in the absence of structural or neurologic laryngeal pathological characteristics. Poorly regulated activity of the intrinsic and extrinsic laryngeal muscles is cited as the proximal cause of functional dysphonia (FD). Recently, the term functional dysphonia has been replaced in some clinical circles by diagnostic label muscle tension dysphonia (MTD), which serves to highlight excess, dysregulated, or imbalanced activity of the intrinsic and extrinsic laryngeal muscles as proximal cause of the observed dysphonia. And recent research evidence points to specific personality traits as important contributors to its development and maintenance. However, the origin of this dysregulated laryngeal muscle activity has not been fully elucidated. Further research is needed to better understand the pathogenesis of functional dysphonia, and factors contributing to its successful management.

소아 성대결절 : 음성치료 후 음성장애지수를 이용한 장기 추적관찰 결과

이성원,노종렬,최승호,김상윤,남순열,Lee, Sung-Won,Roh, Jong-Ryeol,Choi, Seung-Ho,Kim, Sang-Yoon,Nam, Soon-Yuhl 대한후두음성언어의학회 2006 대한후두음성언어의학회지 Vol.17 No.2

Objectives : The purpose of this paper is to know the efficacy of voice therapy for vocal fold nodules in children. Materials and Methods : Sixty two patients with vocal nodules(46 boys and 16 girls) were retrospectively reviewed. Age ranged from 4 to 15 years with mean age of 8 years. Questionnaire survey was carried out with voice handicap index, at pretherapy and post-therapy(3 months and 5 years after voice therapy). Results : Sixty two percent of the patients showed improvement by voice therapy. Twenty five patients continued education at home after voice therapy, but only eight childrens were included this group in pre-school aged children. Voice handicap index was improved in 3 months and 5 years after voice therapy. In contrast, pre-school children group showed slight aggravation in 5 years, especially in emotional subdomain. Conclusion : Voice therapy is effective primary treatment in children with vocal fold nodules. Different result between preschool aged children and school aged group shows needs for age specific approach of voice therapy.

후두개 후두면에 발생한 망상형 신경섬유종 1예

김소연,김태환,이상혁,진성민,Kim, So Yeon,Kim, Tae Hwan,Lee, Sang Hyuk,Jin, Sung Min 대한후두음성언어의학회 2015 대한후두음성언어의학회지 Vol.26 No.2

Neurofibroma is characterized as a benign, slow growing neoplasm, originating from Schwann cells or fibroblast in peripheral nerve sheaths. It may appear as a solitary tumor or have multiple localizations in von Recklinghausen disease. They are commonly found in the gastrointestinal tract and laryngeal neurofibromas are extremely rare, accounting for only 0.03 to 0.1% of benign tumors of the larynx. The aryepiglottic fold and arytenoid are the common site of occurrence for laryngeal neurofibroma, because the branch of the superior laryngeal nerve is involved. We present a case of solitary plexiform neurofibroma arising from the laryngeal surface of epiglottis in a 55-year old female who found the lesion incidentally. We removed the tumor completely by transoral laser surgery and no recurrence was found after 7 months. The case of solitary neurofibroma arising from laryngeal surface of epiglottis has not been reported in Korea. We report this case regarding the diagnosis and treatment with review of literatures.

병적음성에 대한 지속 모음 및 이음절어 발화시 나타나는 음향학적 차이에 대한 연구

채윤정,김범규,홍기환 대한후두음성언어의학회 2000 대한후두음성언어의학회지 Vol.11 No.1

An evaluation of voice disorder has two methods. One is a perceptual analysis and the other is an acoustic analysis. All of these methods are just focused on sustained vowel. The analysis of conversational speech levels in voice disorder has not been achieved enough. The purpose of the present study is to compare two syllable words and sustained vowel in the vocal polyp patients and normal male speakers and to be applied on the vocal assessment and the voice therapy as a basic data. fifteen male patients with vocal polyp were the subject group. Fifteen healthy male were the control group for this study. The voices of the subject and control group, saved in MDVP of CSL were analyzed by its own analysis program. As a results, in subject group, the voice qualities between the vowel following lenis stop and the sustained vowel had no differences, and the voice qualities were different significantly between the vowel following heavily aspirated stop and the sustained vowel. In the control group the vowel fllowing stops and sustained vowel had also many differences in their voice quality, especially significant between the vowel following glottal stop and e sustained vowel.

직업적 음성사용자의 특징

최정석,임재열,김영모,Choi, Jeong-Seok,Lim, Jae-Yol,Kim, Young-Mo 대한후두음성언어의학회 2013 대한후두음성언어의학회지 Vol.24 No.1

The population of professional voice users is increasing in Korea, nowadays. Voice problems in professional voice users cause more negative impact to have their ability to work and maintain their well-being life. In this article, the authors reviewed the characteristics of professional voice users and described the evaluation methods, treatment option and managements in professional voice users.

예기치 못한 후두 입구 협착으로 인한 환기 부전 상황에서의 비디오 후두경의 유용성 1예

문정환,이선홍,강봉진,Moon, Jeong Hwan,Lee, Sun Hong,Kang, Bong Jin 대한후두음성언어의학회 2016 대한후두음성언어의학회지 Vol.27 No.2

Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.

후두외근 과긴장에 대한 음성피로도 검사의 유용성

김지성,이동욱 대한후두음성언어의학회 2021 대한후두음성언어의학회지 Vol.32 No.3

Background and Objectives This study compares Vocal Fatigue Index (VFI) scores according to the presence or absence of external laryngeal tension in hyperfunctional voice disorder. And through this, it is to confirm the usefulness of VFI to hypertension of extrinsic laryngeal muscles.Materials and Method The subjects were 61 female diagnosed with hyperfunctional voice disorder (hypertension group 41, non-hypertension group 20). The author palpated extrinsic laryngeal muscles for evaluation of hypertension and classified them as the presence or absence. The voice measurements were jitter, shimmer, Korean-Voice Handicap Index-10 (K-VHI-10), and Korean-Vocal Fatigue Index (K-VFI). The voice compared were according to the diagnosis and presence of hypertension only for patients with hyperfunctional voice disorder.Results As a result of comparing the voice measurement according to the presence or absence of hypertension, there was no significant difference in the acoustic variables, K-VHI-10 and K-VFI-Total, K-VFI-Fatigue. Whereas, K-VFI-Physical (p=0.006) and K-VFI-Rest (p=0.022) were significantly higher in the hypertension group.Conclusion These results indicate that the hypertension group has more physical discomfort and less voice recovery than the group without hypertension. It means that K-VFI can measure the physical discomfort and limitations of voice recovery due to hypertension of the external laryngeal muscle. The VFI can be used as one of the methods to evaluate the hypertension of the external laryngeal muscle in Hyperfunctional voice disorder.

장시간 지속된 기능적 실성증에 대한 음성치료 1예

김보람,우주현 대한후두음성언어의학회 2022 대한후두음성언어의학회지 Vol.33 No.2

Functional aphonia is a disease in which normal vocal ability is suddenly lost. When voice therapy is started at an early stage, the prognosis is good. However, if the functional aphonia persists for a long time, there is a possibility that the voice disorder may become fixed, though reports of these characteristics are rare. The authors experienced a patient with functional aphonia that occurred in adolescence and lasted for 7 months and reported the result of treatment.

음성직업인의 음성에 관하여

문영일 대한후두음성언어의학회 1991 대한후두음성언어의학회지 Vol.4 No.1

인류발생의 시초부터 인간은 음성을 의사전달, 지식전달, 감정표현의 수단으로 사용하여 왔다. 인간이 만물의 영장이라는 것은 다른 동물과는 달리 음성을 사용하여 말을 할 수 있다는 것이며, 이를 통하여 한 세대에서 다음 세대로 지식과 고유한 문화를 전수해 나갈 수 있는 것이다. (중략)