아데노이드편도 비대, 알레르기성 비염을 가진 아동과 정상 아동의 비성도와 기타 음향 특성

다국어 초록 (Multilingual Abstract)

This paper takes an in-depth comparative study on the children with the disease causing hyponasality (allergic rhinitis, adenotonsillar hypertrophy) and normal children for perceptual, acoustic and instrumental objective evaluations to understand the acoustic characteristics based on its causes. This study also aims to investigate the severity classification as a surgery indicator.
In total, 35 children with adenotonsillar hypertrophy, 33 children with allergic rhinitis and 32 normal children from four years and four months(52 months) to nine years and eleven months(119months) were investigated for this research. Three vowels /a, i. u/, 0% of nasal consonant {bada} sentence, 50% of nasal consonant {dongmulwon}, 100% of nasal consonant {eumma} were used for this investigation. Tascam(dr05) recorder and nasometer were used for the voice recording.
One-way ANOVA analysis was resulted in followings.
First, there was a significant difference between two groups in shimmer-apq5 by Cepstrum variable and voice recording from {dongmulwon} and {eumma} sentence. {dongmulwon} sentence had significant differences by shimmer-apq11 which is a Cepstrum variable with nasometer voice recording, by shimmer_apq3 of vowel /a/ and by shimmer-ddp. Those two suggested that a group with allergic rhinitis and a group with adenotonsillar hypertrophy had greater shimmer values compared to a normal group (4.04/4.21).
Second, HNR(Harmonic to Noise Ratio) which is a vocal feature of nasometer recoding had a meaningful difference among three groups in vowel /a/. A normal group > a group with adenotonsillar hypertrophy > a group with allergic rhinitis had greater values in sequence.
Third, acoustic characteristics of voice variables from nasometer recording showed a meaningful difference from all those sentences. The sentences with 0% of nasal consonant {bada}, 50% of nasal consonant {dongmulwon} and 100% of nasal consonant {eumma} had significant differences between groups.
Fourth, the skewness of spectrum variable from Tascam recording of vowel /a/, the skewness and kurtosis from the spectrum starting point to the maximum amplitude of vowel /i/, the cepsSlope of {bada} and {eumma} from data in nasometer recording and cpp_m of vowel /a/ had the greatest value in a group with adenotonsillar hypertrophy(p<.05).
Fifth, auditory-perceptive evaluation rating scores of the data from Tascam recording and hyponasality from the date in nasometer recording corresponded each other. The group with adenotonsillar hypertrophy had the highest hyponasality.
To investigate the acoustic variables affecting groups and to evaluate the mirror-fogging test along with sound characteristics, the discriminant analysis was applied for the classification accuracy. The results are as follows.
First, {bada} of the data from Tascam recording and {eumma} from data in nasometer recording had 52% and the greatest discrimination variables were shim_apq5 and nNasalance.
Second, {eumma} and {bada} from recording data in nasometer had 51% of classification accuracy and the nNasalance was the greatest discrimination.
Third, nNasalance and mirror-fogging test results were analyzed to understand the influence on the nNasalance and mirror-fogging test to those three groups. It resulted in 30~41% of classification accuracy only with nNasalance, 60% of classification accuracy only with mirror-fogging test result. The classification accuracy with mirror-fogging test was 19~30% higher than with nNasalance.
Fourth, the nNasalance was the best variable which could well evaluate resonance disorders among all of the variables. Shimmer derived variables and moment variables such as skewness, kurtosis and standard deviation were proved to better classify the groups with resonance disorders in case Tascam(dr05) data.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 목적 및 필요성 1
• 2. 연구문제 4
• 3. 용어의 정의 5
• Ⅱ. 이론적 배경 6
• 1. 공명장애 6
• 2. 공명장애 평가 7
• 3. 아데노이드 편도 비대 (Adenotonsillar hypertrophy) 12
• 4. 알레르기성 비염 (Allergic rhinitis) 15
• 5. 나조미터를 이용하여 비성도를 측정한 선행연구 15
• 5.1 정상 아동을 대상으로 한 연구 15
• 5.2 정상 성인을 대상으로 한 연구 17
• 5.3 구개열 및 아데노이드편도 비대 아동을 대상으로 한 연구 18
• 5.4 비염 및 아데노이드 편도 비대 성인을 대상으로 한 연구 20
• 5.5 음성 음향학적 특성과 관련된 선행연구 21
• 5.6 선행연구를 통하여 본 정상 비성도의 평균 24
• 6. 변수설명 26
• Ⅲ. 연구방법 37
• 1. 연구대상 37
• 2. 검사도구 39
• 2.1 검사어 39
• 2.2 녹음 방법 39
• 3. 분석절차 및 통계처리 40
• 3.1 청지각 평가 41
• 3.2 통계 42
• Ⅳ. 연구결과 43
• 1. 평가자내 신뢰도(Intra-rater reliability correlation coefficient) 43
• 2. 평가자간 신뢰도(Inter-rater reliability correlation coefficient) 44
• 3. 비성도와 기타 음향변수에 대한 집단 간 차이 44
• 3.1 타스캄 녹음 데이터의 스펙트럴 영역에서의 문장별 음향변수 45
• 3.2 타스캄 녹음 데이터의 스펙트럴 영역에서의 모음별 음향변수 48
• 3.3 타스캄 녹음 데이터의 음성캡스트럴 영역에서의 문장별 음향변수 53
• 3.4 타스캄 녹음 데이터의 음성캡스트럴 영역에서의 모음별 음향변수 60
• 3.5 타스캄 녹음의 공명주파수 영역에서의 모음별 음향변수 64
• 3.6 나조미터 녹음 데이터의 스펙트럴 영역에서의 문장별 음향변수 70
• 3.7 나조미터 녹음 데이터의 스펙트럴 영역에서의 모음별 음향변수 75
• 3.8 나조미터 녹음 데이터의 음성캡스트럴 영역에서의 문장별 음향변수 78
• 3.9 나조미터 녹음 데이터의 음성캡스트럴 영역에서의 모음별 음향변수 85
• 4. 상관관계 분석 90
• 4.1 청지각 평가와 변수별 상관관계 90
• 4.2 비성도와 음향변수 사이의 상관관계 90
• 5. 판별분석(Discriminant Analysis) 92
• 5.1 타스캄 녹음 데이터의 스펙트럴 영역에서의 판별분석 93
• 5.2 타스캄 녹음 데이터의 음성캡스트럴 영역에서의 판별분석 96
• 5.3 타스캄 녹음 데이터의 공명 주파수 영역에서의 판별분석 102
• 5.4 나조미터 녹음 데이터의 스펙트럴 영역에서의 판별분석 105
• 5.5 나조미터 녹음 데이터의 음성캡스트럴 영역에서의 판별분석 111
• 5.6 전체 분류 정확도에 따른 판별식 순위와 유의미 변수 117
• 5.7 비성도와 mirror-fogging test 결과의 전체분류정확도 비교 119
• Ⅴ. 논의 및 결론 122
• 참고문헌 132
• ABSTRACT 147