후두의 신경학적 음성장애의 특성과 음성 치료

김지원 대한후두음성언어의학회 2025 대한후두음성언어의학회지 Vol.36 No.1

The larynx plays a crucial role in respiration, phonation, and swallowing, with its motor and sensory functions controlled by both the central and peripheral nervous systems. Neurological voice disorders arise when various neurological diseases, such as sensory impairment, motor weakness, reflex abnormalities, or incoordination, affect the laryngeal function. Patients with neurological conditions often present with voice changes, swallowing difficulties, or respiratory issues, leading them to seek evaluation and treatment from otolaryngologists, sometimes resulting in neurological consultation. Laryngeal motor disorders can be caused by dysfunction in the cerebral cortex, basal ganglia, midbrain, or cerebellum. Neurological voice disorders are often subtle at first and may become more pronounced as the disease progresses, commonly accompanied by other speech disorders such as dysarthria or aphasia. Early diagnosis of symptoms and understanding the characteristics of neurological diseases is crucial for effective voice evaluation and therapy. This review summarizes the clinical features, voice characteristics, and treatments of diseases that cause neurological voice disorders, including essential tremor, Parkinson’s disease, amyotrophic lateral sclerosis, stroke, myasthenia gravis, and multiple sclerosis. Understanding the specific voice characteristics and appropriate treatment options for each condition is essential for improving communication outcomes in these patients. Additionally, addressing coexisting swallowing disorders is important when treating neurological voice disorders.

다기관 설문조사를 통한 국내 소아 음성질환 환자의 검사 및 치료 유형 연구

이종근,방승환,전재민,이정규,김연,우정수,조재구 대한후두음성언어의학회 2019 대한후두음성언어의학회지 Vol.30 No.1

Background and Objectives:Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. Materials and Method:An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. Results:Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pretreatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. Conclusion:Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

코로나바이러스 감염증-19 진단검사에 위음성을 보인 후두전절제 환자 1예

백문승,권혁로,김승우 대한후두음성언어의학회 2022 대한후두음성언어의학회지 Vol.33 No.1

The coronavirus disease (COVID-19) by severe acute syndrome coronavirus-2 (SARS-CoV-2) occurs the unprecedented pandemic during recent two years and the WHO declared a global pandemic of COVID-19 in March 2020. The most common sampling sites in COVID-19 test are the oropharynx and nasopharynx. We recently encountered a total laryngectomee who had a positivity COVID-19 diagnostic test from the tracheostoma, on the other hand, false negativity from the nasal cavity. The meaning of this case is that accurate screening test could be achieved by performing a test through the tracheostoma as well as nasal cavity or oropharynx. We also would like to discuss the accurate testing methods of patients whose airflow has distorted due to surgery, the management method of these patients, and the need of further research in the COVID-19 pandemic period with relevant literature reviews.

음성장애 환자에서 시행되는 청지각적 평가에 대한 논의

이승진 대한후두음성언어의학회 2021 대한후두음성언어의학회지 Vol.32 No.3

The auditory-perceptual evaluation of speech-language pathologists (SLP) in patients with voice disorders is often regarded as a touchstone in the multi-dimensional voice evaluation procedures and provides important information not available in other assessment modalities. Therefore, it is necessary for the SLPs to conduct a comprehensive and in-depth evaluation of not only voice but also the overall speech production mechanism, and they often encounter various difficulties in the evaluation process. In addition, SLPs should strive to avoid bias during the evaluation process and to maintain a wide and constant spectrum of severity for each parameter of voice quality. Lastly, it is very important for the SLPs to perform a team approach by documenting and delivering important information pertaining to auditory-perceptual characteristics in an appropriate and efficient way through close communication with the laryngologists.

갑상선 수술 후 음성 변화에 대한 비대면 음성언어치료 증례

이길준,박수나,Lee, GilJoon,Park, Su Na 대한후두음성언어의학회 2021 대한후두음성언어의학회지 Vol.32 No.1

Voice therapy is effective in many voice and speech disorders. However, patients have low accessibility to therapeutic facilities due to disease-unrelated reasons such as lack of time and pandemic of COVID-19. Contactless voice therapy could be an alternative and may helpful to all patients with voice and speech problems. We developed contactless voice and speech therapy program on the necessity of improving accessibility. Herein, we report the first case of voice therapy to 30 year-old female patient who complained voice change after total thyroidectomy using contactless voice and speech therapy service platform in Korea.

후두음성의학에서 딥러닝을 이용한 음성장애 검출에 관한 예비 연구

김광현,조재근 대한후두음성언어의학회 2025 대한후두음성언어의학회지 Vol.36 No.1

Background and Objectives Voice disorders can significantly impact quality of life. This study evaluates the feasibility of using deep learning models to detect voice disorders using an opensource dataset. Materials and Method We utilized the Saarbrücken Voice Database, which contains 1231 voice recordings of various pathologies. Datasets were used for training (n=1036) and validation (n=195). Key vocal parameters, including fundamental frequency (F0), formants (F1, F2), harmonics-to-noise ratio, jitter, and shimmer, were analyzed. A convolutional neural network (CNN) was designed to classify voice recordings into normal, vox senilis, and laryngocele. Performance was assessed using precision, recall, F1-score, and accuracy. Results The CNN model demonstrated high classification performance, with precision, recall, and F1-scores of 1.00 for normal and 0.99 for vox senilis and laryngocele. Accuracy reached 1.00 after 50 epochs and remained stable through 100 epochs. Time-frequency analysis supported the model’s ability to differentiate between classes. Conclusion This study highlights the potential of deep learning for voice disorder detection, achieving high accuracy and precision. Future research should address dataset diversity and realworld integration for broader clinical adoption.

성대 폴립 환자에 대한 후두미세수술과 음성 치료의 전, 후 결과 비교

김근효,임동원,천용일,신성찬,이병주,이연우 대한후두음성언어의학회 2024 대한후두음성언어의학회지 Vol.35 No.2

Background and Objectives The aim of this study is to compare the acoustic and auditory-perceptual assessment of patients with vocal fold polyps (VP) before and after laryngeal microsurgery (LMS) and voice therapy (VT).Materials and Method A retrospective cohort design was employed. Sustained vowels and continuous speech samples produced by 36 patients diagnosed with VP were analyzed. Treatment outcome measures included, cepstral peak prominence (CPP), smoothed cepstral peak prominence (CPPS), acoustic voice quality index (AVQI), acoustic breathiness index (ABI), auditory-perceptual (A-P) ratings (G of GRBAS scale and overall severity [OS] of consensus auditory-perceptual evaluation of voice), and voice handicap index-10 (VHI-10).Results Following LMS and VT, significant improvements in CPP, CPPS, AVQI, ABI (p<0.001) were observed. Additionally, A-P ratings (G and OS) and VHI-10 (p<0.001) significantly improved following LMS and VT. Acoustic analyses, A-P ratings and VHI-10 indicated that the voice quality has improved following LMS and VT.Conclusion Our study demonstrates that the concurrent application of LMS and VT in patients with VP leads to improvements in both voice quality and patient satisfaction. These findings underscore the importance of a multidisciplinary approach in the management of VP, integrating both surgical and therapeutic interventions for optimal outcomes.

후두음성 질환에 대한 인공지능 연구

석준걸,권택균 대한후두음성언어의학회 2022 대한후두음성언어의학회지 Vol.33 No.3

Diagnosis using voice is non-invasive and can be implemented through various voice recording devices; therefore, it can be used as a screening or diagnostic assistant tool for laryngeal voice disease to help clinicians. The development of artificial intelligence algorithms, such as machine learning, led by the latest deep learning technology, began with a binary classification that distinguishes normal and pathological voices; consequently, it has contributed in improving the accuracy of multi-classification to classify various types of pathological voices. However, no conclusions that can be applied in the clinical field have yet been achieved. Most studies on pathological speech classification using speech have used the continuous short vowel /ah/, which is relatively easier than using continuous or running speech. However, continuous speech has the potential to derive more accurate results as additional information can be obtained from the change in the voice signal over time. In this review, explanations of terms related to artificial intelligence research, and the latest trends in machine learning and deep learning algorithms are reviewed; furthermore, the latest research results and limitations are introduced to provide future directions for researchers.

성대 폴립 환자에 대한 후두미세수술과 음성 치료의 전, 후 결과 비교

김근효,임동원,천용일,신성찬,이병주,이연우 대한후두음성언어의학회 2024 대한후두음성언어의학회지 Vol.35 No.1

Background and Objectives The aim of this study is to compare the acoustic and auditory-perceptual assessment of patients with vocal fold polyps (VP) before and after laryngeal microsurgery (LMS) and voice therapy (VT).Materials and Method A retrospective cohort design was employed. Sustained vowels and continuous speech samples produced by 36 patients diagnosed with VP were analyzed. Treatment outcome measures included, cepstral peak prominence (CPP), smoothed cepstral peak prominence (CPPS), acoustic voice quality index (AVQI), acoustic breathiness index (ABI), auditory-perceptual (A-P) ratings (G of GRBAS scale and overall severity [OS] of consensus auditory-perceptual evaluation of voice), and voice handicap index-10 (VHI-10).Results Following LMS and VT, significant improvements in CPP, CPPS, AVQI, ABI (p<0.001) were observed. Additionally, A-P ratings (G and OS) and VHI-10 (p<0.001) significantly improved following LMS and VT. Acoustic analyses, A-P ratings and VHI-10 indicated that the voice quality has improved following LMS and VT.Conclusion Our study demonstrates that the concurrent application of LMS and VT in patients with VP leads to improvements in both voice quality and patient satisfaction. These findings underscore the importance of a multidisciplinary approach in the management of VP, integrating both surgical and therapeutic interventions for optimal outcomes.

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)