Yaelin Choi

Radiofrequency thyroarytenoid myothermy for treatment of adductor spasmodic dysphonia: how we do it

Dear Editor, Adductor spasmodic dysphonia is a neurological voice disorder characterised by action-induced, task-specific spasm of the vocal folds. During the past decade, botulinum toxin has emerged as an accepted treatment for adductor spasmodic dysphonia. However, this treatment has some limitations and therefore a variety of surgical therapies for adductor spasmodic dysphonia have been proposed. Recently, Remacle reported a promising outcome with transoral bipolar radiofrequency (RF)-induced thermotherapy by coagulating terminal branches of the recurrent laryngeal nerve in three patients with adductor spasmodic dysphonia. We performed a clinical trial of patients with adductor spasmodic dysphonia with a modified Remacle’s procedure. Instead of coagulating the distal part of one recurrent laryngeal nerve, we ablated portions of the thyroarytenoid muscles.

Comparison of Aerodynamic Variables according to the Execution Methods of KayPENTAX Phonatory Aerodynamic System Model 6600

In case of PAS test, the air is sometimes leaked although the mask is tightly attached to the face, which is not reliable on the measured values. Therefore, this study aimed to assist the clinical practice suggesting the test method of PAS without air leakage. In the healthy subjects with 12 males and 12 females over 19 years old, three types of tests were performed on the voicing efficiency among the protocol of PAS Model 6600. They are; first, to attach the mask tightly to the face holding the handle of PAS with the subject`s two hands (Method 1); second, to attach the mask tightly to the face holding the handle of PAS with the subject`s one hand and pushing the body of PAS strongly with the other hand (Method 2); and third, to attach the mask tightly to the face pushing the upper part of the mask by the tester when the subject attached the mask to his or her face holding the handle of PAS with two hands (Method 3). Upon the study analyses, the mean negative pressure, the mean phonogram, subglottic air pressure, and voicing efficiency were shown to be statistically significantly different during PAS test in males depending on the methods. (p

The Aspect of Voice Characteristics Change after Botulinum Toxin-A Injection in Patients with Adductor Spasmodic Dysphonia according to Vocal Tremor

As BTX-A, which has been known to be the most effective treatment for ADSD, is not effective in treating vocal tremors, voice assessment must be employed to perform differential diagnosis of SD and vocal tremor in an accurate fashion. In this study, the characteristics of vocal changes after botulinum toxin injection were compared by analyzing the voice characteristics resulting from the presence of vocal tremors using objective analysis devices, with the aim of helping to provide prognoses and to determine remedial effects in clinical cases comprising patients with adductor spasmodic dysphonia accompanied by voice tremors. Respiratory function tests, aerodynamic analysis, electroglottography (EGG), acoustic analysis, auditory perception tests, and K-VHI had been conducted at intervals of four, eight, and twelve weeks before and after injection, targeting a group of 17 ADSD female patients (a ADSD group of four with vocal tremor and a ADSD group of 13 without voice tremor). For average FVC and FEV1, the T group showed statistically significant low averages compared with the NT group, whereas the T group showed statistically significant high average ATRI compared with the NT group. In addition, the T group showed a statistically significant Fatr, lower than that of the NT group. For the ADSD group of patients with voice tremor, their vocal tremor remained unchanged despite noticeable decrease in wringing voices. In other words, as the vocal tremor and wringing voices are two distinctive features, there is a need for the two features to be targeted separately for differential diagnosis.

Characteristics of respiration and phonation depending on smoking or non smoking by practical musicology students and general male students

ABSTRACT This research compared the features of respiration and phonation between practical musicology students and general male students, according to their smoking status. Participants of this research are 15 practical musicology male students attending ○○ university and 16 general ○○○ university students. The participants, both non-smokers and smokers with 5-years of smoking history have no history of voice disease in any case and have normal cognitive functions. The results indicated that, first, there is not a notable difference in the respiratory activity status(FVC, FEV1, FEV1/FVC), regardless of major and smoking status. In MPT, even though there is no significant difference in accordance with their majors, considering smoking status, the smoker group was shorter than non-smoker group significant difference statistically (p<.01). Second, the divisions of participants’ major did not show significant difference in Fo, jitter, shimmer, and NHR in the vowel prolongation task. However, the smoker group showed a significantly higher degree of jitter and shimmer than the non-smoker group (p<.05) as Fo and NHR shows no difference. In the case of VRP, maximum frequency and frequency range of the practical group are significantly higher than normal group statistically (p<.001). Moreover, although the difference of the minimum frequency shown at the statistic is not significant, practical group showed a higher tendency of frequency than normal group (p=.051). In conclusion, even though there is no difference in respiratory activity between the smoker group and non-smoker group, the MPT of the smoker group is shorter than that of non-smoker group. In addition, the smoker group showed a higher degree of jitter and shimmer than the non-smoker group. MPT is related to the valve action of vocal fold that passes through the glottis. Thus, it is interpreted that the smoker group has a lower quality of voice and valve action of the vocal fold. Also, the practical group has a higher degree of maximum frequency and frequency range than the normal group. This research can function as basic data for vocal characteristics for the majors in relation to the voice-specializing. Keywords: acoustic characteristic, Maximum phonation time, respiratory, Voice range profile, practical musicology, smoking

Comparison of Maximum Phonation Time Associated with the Changes in Vocal Intensity in Patients with Unilateral Vocal Fold Palsy and Sulcus Vocalis

The patients with incomplete glottic closure have an important feature decreasing the maximum phonation time (MPT) because airflow rate or air leakage is greater than people without voice disorders. Also they can appear a problem in the intensity regulation. This study analyzed MPT difference based on the comfortable intensity and louder intensity and the correlation between MPT and respiration volume of unilateral vocal fold palsy (UVFP) and sulcus vocalis (SV) group. The twenty with UVFP, the 21 with SV, the 21 normal subjects measured MPT in /a/ vowel prolongation task with comfortable intensity and louder intensity and compared analysis by measuring FVC, , to analyze the correlation between MPT and respiration volume. First, a comparison of MPT according to the intensity between groups is that MPT of the normal group was statistically significant long compared to the patient group in comfortable intensity, but MPT between groups was not statistically significant difference in the louder intensity. Second, an analysis of the correlation between MPT and respiration volume is that this was statistically significant correlation between MPT in comfortable intensity and MPT in louder intensity. But this did not show statistically significant correlation between intensity and respiration volume. This study can be supported the preceding study results deduced that shorting MPT of the patient group compared to the normal group was originated in the problem of laryngeal valving mechanism at the level of vocal folds rather than a problem of respiratory function. Also at the phonation by varying the intensity, the result can deduce that in the case of patient group, the length of MPT had been improved by increasing the glottal closure ratio in the louder intensity. These results can support the theoretical basis that should be applied to the clinicians by varying the intensity at the voice evaluation and voice therapy for the patients with the glottis incompetence.