생체피드백 음성치료가 변성발성장애 환자의 음성개선에 미치는 효과

Abstract

Mutational dysphonia is defined as the failure to change from the high-pitched voice of the pre-adolescence to the lower pitched voice of adulthood. It is a kind of voice disorders due to the failure to acquire proper low pitched voice during the puberty. The patients with mutational dysphonia can produce the normal low pitched voice by the surgical treatment, like the type III thyroplasty, or the voice therapy. Fourteen patients with mutational dysphonia voices showed that high pitch is a common sign and symptom. The purpose of this article is to evaluate the changes brought about by the biofeedback voice therapy, using the analysis of the laryngoscope measure as well as acoustics, aerodynamics. The 14 patients who were diagnosed as mutational dysphonia by the laryngologists, and treated by the speech pathologist were selected as subjects. Their voices of pre-therapy and post-therapy were analyzed on the aspects of acoustics, aerodynamics and laryngeal endoscope. Acoustic analysis was done by the MDVP of CSL, aerodynamic analysis, by the maximum phonation time and local finding by the laryngoscope. By these measurements, we could find that fundamental frequency(Fo) was significantly lowered on the average, 121.4Hz, Maximum phonation time(MPT) was increased 2.5 second, and jitter was decreased 0.828%, respectively, and each changes was statistically significant, too. On the average, shimmer was decreased 2.180%, and NHR was decreased 0.005 which was the only parameter not showing improvement. But the changes of jitter, NHR were not statistically significant. In patients with mutational dysphonia, a narrow thyrohyoid space, elevation of the larynx , and severe contraction of the suprahyoid muscles were detected during phonation. Also the voice of most patients improved greatly and became normal within 5 sessions.