성대용종 환자의 음성치료 효과
The Effect of Voice Therapy in Vocal Polyp Patients
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초록
Vocal polyps are benign phonotraumatic lesions which are traditionally treated using phonomicrosurgical techniques. In the case of hyperfunctional voice use, voice therapy is effective and results in voice improvement. However, the utility of voice therapy about vocal polyp is in great demand. The purpose of this study was to evaluate the effects of voice therapy in patients with vocal polyps. The authors reviewed the medical records of 193 patients with vocal nodules or vocal polyps, and 64 patients (31 nodules and 33 polyps) were enrolled. All of the subjects had received explanation of problems, vocal hygiene education, and been treated by the SKMVTT® (Seong-Tae Kim's multiple voice therapy technique) ranging from 4 to 16 sessions (mean: 8.6 sessions). All subjects were examined by perceptual assessment, acoustic and aerodynamic measures, and VRP (voice range profile). In perceptual assessment, patients with vocal nodules had more breathy and strained voices than the vocal polyp group. Both groups significantly reduced rough, breathy voice after voice therapy. Patients with vocal polyps had worse voice quality than patients with nodules in acoustic measures. Both groups showed reduced jitter and shimmer after voice therapy. In aerodynamic measures, MPT and Psub were increased, and MFR was reduced (p<.05). Participants' frequency range and intensity range were increased after voice therapy, but only frequency range resulted in a significant difference (p<.05). In conclusion, the therapeutic effect of voice therapy in patients with vocal nodules and polyps was demonstrated perceptually and acoustically. We can suggest that voice therapy, including advice, vocal hygiene, and SKMVTT® is a useful as an initial choice of treatment for patients with vocal polyps before considering a surgical approach.
Abstract
Vocal polyps are benign phonotraumatic lesions which are traditionally treated using phonomicrosurgical techniques. In the case of hyperfunctional voice use, voice therapy is effective and results in voice improvement. However, the utility of voice therapy about vocal polyp is in great demand. The purpose of this study was to evaluate the effects of voice therapy in patients with vocal polyps. The authors reviewed the medical records of 193 patients with vocal nodules or vocal polyps, and 64 patients (31 nodules and 33 polyps) were enrolled. All of the subjects had received explanation of problems, vocal hygiene education, and been treated by the SKMVTT® (Seong-Tae Kim's multiple voice therapy technique) ranging from 4 to 16 sessions (mean: 8.6 sessions). All subjects were examined by perceptual assessment, acoustic and aerodynamic measures, and VRP (voice range profile). In perceptual assessment, patients with vocal nodules had more breathy and strained voices than the vocal polyp group. Both groups significantly reduced rough, breathy voice after voice therapy. Patients with vocal polyps had worse voice quality than patients with nodules in acoustic measures. Both groups showed reduced jitter and shimmer after voice therapy. In aerodynamic measures, MPT and Psub were increased, and MFR was reduced (p<.05). Participants' frequency range and intensity range were increased after voice therapy, but only frequency range resulted in a significant difference (p<.05). In conclusion, the therapeutic effect of voice therapy in patients with vocal nodules and polyps was demonstrated perceptually and acoustically. We can suggest that voice therapy, including advice, vocal hygiene, and SKMVTT® is a useful as an initial choice of treatment for patients with vocal polyps before considering a surgical approach.
참고문헌 (16)
- 김 성 태, "다중음성치료기법(SK-MVTT)이 성대결절 환자의 음성개선에 미치는 효과:", 음성과학, 11(4), pp.101~120 (2004), 한국음성과학회
- 김성태, "웃음을 이용한 다중음성치료기법(SKMVTT?)이 성대용종 환자의 음성개선에 미치는 효과", 음성과학, 15(2), pp.157~168 (2008), 한국음성과학회
- 김형태, "양성성대질환의 기저막영역과 고유층 최상층의 조직병리학적 변화에 따른 병인학적 가설", 대한이비인후과학회지 두경부외과학, 48(1), pp.65~69 (2005), 대한이비인후과학회
- 윤영선, "성대 폴립 환자에서 음성위생교육의 효과", 대한이비인후과학회지 두경부외과학, 49(7), pp.728~732 (2006), 대한이비인후과학회
- Aronson, A. E, "Clinical voice disorder: An interdisciplinary approach" (1990), Thieme Inc
- Benninger, M. S, "Vocal nodules, microwebs, and surgery", Journal of Voice, 9(3), pp.326~331 (1995)
- Cohen, S. M, "Utility of voice therapy in the management of vocal fold polyps and cyst", Otolaryngology Head and Neck Surgery, 136, pp.742~746 (2007)
- Courey, M. S, "Medical microflap for excision of benign vocal fold lesions", Laryngoscope, 107, pp.340~344 (1997)
- Greene, M. C, "The Voice and its Disorder" (1980), Lippincott Co
- Hochman, I. I, "Phonomicrosurgical management of vocal fold polyps: The subepithelial microflap resection technique", Journal of Voice, 14(1), pp.112~118 (2000)
- Johns, M. M, "Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps and cyst", Current Opinion in Otolaryngology & Head and Neck Surgery, 11, pp.456~461 (2003)
- Klein, A. M, "Spontaneous resolution of hemorrhagic polyps of the true vocal fold", Journal of Voice, 23(1), pp.132~135 (2009)
- McCrory, E, "Voice therapy outcomes in vocal fold nodules: a retrospective audit", Int J Lang Commun Disord, 36, pp.19~24 (2001)
- Sulica, L, "Management of benign vocal fold lesions: a survey of current opinion and practice", The Annal of Otology, Rhinology, and Laryngology, 112, pp.827~833 (2003)
- Wallis, L, "Vocal fold nodules vs. vocal fold polyp: answer from surgical pathologist and voice pathologist point of view", Journal of Voice, 18(1), pp.125~129 (2004)
- Zeitels, S. M, "Phonomicrosurgery in singers and performing artists: treatment outcomes, management theories, and future directions", The Annal of Otology, Rhinology, and Laryngology, 190, pp.21~40 (2002)