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성대돌기 육아종의 음성치료 효과

The Effects of Voice Therapy in Vocal Process Granuloma

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초록

Vocal process granuloma can occur commonly by laryngopharyngeal reflux (LPR), vocal abuse or misuse. It has been reported that voice therapy is employed with medication therapy for the patients who has vocal process granuloma, however research about effect of voice therapy can be hardly founded. For that matter, the primary aim of this study was to evaluate the effect of therapeutic method we implement. Thirty one patients who has been diagnosed with vocal process granuloma from January, 2007 to June, 2009 participated in this study. 19 patients among them are provided voice therapy and medication, 12 patients take only medication. Voice therapy is implemented ranging from 5 to 19 sessions (mean: 8.6 sessions). We provided explanation about problem each patient has, voice rest, SKMVTT®, abdominal breathing, and relaxation in session. All subjects were examined by videostroboscopy, perceptual assessment, acoustic and aerodynamic measures. Consequantly, the greater part of the patients (78.9%) who is treated by voice therapy and medication are confirmed disappearance or decrease of granuloma, it shows better results compared with the group provided only medication (66.7%). Especially, the period of drug administration is 3.7 months in the group runs parallel with voice therapy, the period of other group is 7.8 months. The results of acoustic and aerodynamic measures after treating indicates there are significant decrease in Jitter, Shimmer, and NHR, and increase in MPT, Psub (p<.05). However, there is no large difference statistically even though voice quality has improved since the therapy. In conclusion, it is verified that the voice therapy to the vocal process granuloma patients taking medication is effectual method, we recommend combining voice therapy with medication when treatment is needed for the vocal process granuloma patients.

Abstract

Vocal process granuloma can occur commonly by laryngopharyngeal reflux (LPR), vocal abuse or misuse. It has been reported that voice therapy is employed with medication therapy for the patients who has vocal process granuloma, however research about effect of voice therapy can be hardly founded. For that matter, the primary aim of this study was to evaluate the effect of therapeutic method we implement. Thirty one patients who has been diagnosed with vocal process granuloma from January, 2007 to June, 2009 participated in this study. 19 patients among them are provided voice therapy and medication, 12 patients take only medication. Voice therapy is implemented ranging from 5 to 19 sessions (mean: 8.6 sessions). We provided explanation about problem each patient has, voice rest, SKMVTT®, abdominal breathing, and relaxation in session. All subjects were examined by videostroboscopy, perceptual assessment, acoustic and aerodynamic measures. Consequantly, the greater part of the patients (78.9%) who is treated by voice therapy and medication are confirmed disappearance or decrease of granuloma, it shows better results compared with the group provided only medication (66.7%). Especially, the period of drug administration is 3.7 months in the group runs parallel with voice therapy, the period of other group is 7.8 months. The results of acoustic and aerodynamic measures after treating indicates there are significant decrease in Jitter, Shimmer, and NHR, and increase in MPT, Psub (p<.05). However, there is no large difference statistically even though voice quality has improved since the therapy. In conclusion, it is verified that the voice therapy to the vocal process granuloma patients taking medication is effectual method, we recommend combining voice therapy with medication when treatment is needed for the vocal process granuloma patients.

참고문헌 (11)

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  2. Emami, A. J., "Treatment of laryngeal contact ulcer and granuloma: a 12-year retrospective analysis", Journal of Voice, 13, pp.612~617 (1999)
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  4. 이진춘, "성대돌기 육아종(Vocal Process Granuloma)의 치료", 대한이비인후과학회지 두경부외과학, 48(1), pp.70~73 (2005), 대한이비인후과학회
  5. Leonard, R., "Effects of voice therapy on vocal process granuloma: a phonoscopic approach", American Journal of Otolaryngology, 26, pp.101~107 (2005)
  6. 김 성 태, "다중음성치료기법(SK-MVTT)이 성대결절 환자의 음성개선에 미치는 효과:", 음성과학, 11(4), pp.101~120 (2004), 한국음성학회
  7. 김성태, "성대용종 환자의 음성치료 효과", 말소리와 음성과학, 1(2), pp.43~49 (2009), 한국음성학회
  8. 고문희, "후두 접촉성 육아종의 치료", 대한음성언어의학회지, 19(2), pp.128~132 (2008)
  9. Maier, W., "Pathogenetic and therapeutic aspects of contact granuloma", Laryngorhinootologie, 73, pp.488~491 (1994)
  10. Orloff, A. L., "Vocal fold granuloma: successful treatment with botulinum toxin", Otolaryngology -Head and Neck Surgery, 121, pp.410~413 (1999)
  11. Ylitalo, R., "Voice characteristics, effects of voice therapy, and long-term follow-up of contact granuloma patients", Journal of Voice, 14, pp.557~566 (2000)

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