Kas gerilimi disfonisi tip 1 hastalığı ile yumuşak fonasyon indeksi arasındaki ilişki ve ses terapisinin etkinliği

Yıl 2008, Cilt: 18 Sayı: 3, 131 - 138, 25.06.2008

Serkan Bengisu Seyhun Topbaş İsmail Koçak

Öz

Amaç: Kas gerilimi disfonisi KGD tip 1 ile yumuşak fonasyon indeksi YFİ parametresi arasındaki ilişki araştırıldı ve bu hastalara uygulanan ses terapisinin etkinliği değerlendirildi. Hastalar ve Yöntemler: Çalışmaya videolarengostroboskopik inceleme ile KGD tip 1 tanısı konan 20 hasta tümü kadın; ort. yaş 27±6 alındı. Olgulara ses terapisi öncesinde ve sonrasında Çokboyutlu Ses Programı Multi-Dimensional Voice Program ile akustik analiz yapıldı. Akustik parametreler herhangi bir ses sorunu bulunmayan 20 kişilik kontrol grubu tümü kadın; ort. yaş 28±4 ile karşılaştırıldı. Bulgular: Hasta grubunda 20 hastanın 19’unda YFİ parametresinde bozulma saptanırken, kontrol grubunda bu durum yalnızca iki olguda gözlendi p

Anahtar Kelimeler

Fonasyon, ses spektrografisi, konuşma akustiği, konuşma terapisi, ses hastalıkları/tanı, ses kalitesi, ses eğitimi

The relationship between muscle tension dysphonia type 1 and soft phonation index and the effectiveness of voice therapy

Öz

Objectives: We investigated the relationship between muscle tension dysphonia MTD type 1 and soft phonation index SPI and evaluated the effect of voice therapy on MTD type 1. Patients and Methods: The study included 20 patients all females; mean age 27±6 years whose diagnosis was made as MTD type 1 on videolaryngostroboscopic examination. Acoustic analysis was performed before and after voice therapy using the Multi-Dimensional Voice Program. Acoustic parameters were compared with those of a control group comprising 20 females mean age 28±4 years without any voice problem. Results: In the patient group, 19 patients exhibited significantly increased SPI compared to two subjects in the control group p<0.05 . The most significant improvements were seen in SPI, jitter, and PPQ following voice therapy, which was found to be effective in 19 patients. Conclusion: Our findings showed a close relationship between MTD type 1 and SPI. Voice therapy improves parameters of amplitude and frequency perturbations, in particular SPI.

Anahtar Kelimeler

Phonation, sound spectrography/methods, speech acoustics, speech therapy, voice disorders/diagnosis, voice quality, voice training

Kaynakça

• Colton RH, Casper JK, editors. Understanding voice problems: a physiological perspective for diagnosis and treatment. 2nd ed. Baltimore: Williams & Wilkins; 1996.
• Boone DR, McFarlane SC, editors. The voice and voice therapy. 6th ed. Boston: Allyn & Bacon; 1999.
• Üstündağ E, Oğuz A. Fonksiyonel ses bozuklukları. In: Oğuz A, Demireller A, editörler. Ses ve ses hastalıkları. İstanbul: Ekin Tıbbi Yayıncılık; 1996. s. 73-84.
• Koufman JA, Blalock PD. Classification and approach to patients with functional voice disorders. Ann Otol Rhinol Laryngol 1982;91(4 Pt 1):372-7.
• Morrison MD, Rammage LA. Muscle misuse voice dis- orders: description and classification. Acta Otolaryngol 1993;113:428-34.
• Koçak İ, Dursun G, Demireller A. Fonksiyonel dis- fonilerde laringostroboskopi ile vizüel biofeedback terapi. In: Oğuz A, Demireller A, editörler. Ses ve ses hastalıkları. İstanbul: Ekin Tıbbi Yayncılık; 1996. s. 85-92.
• Birkent H. Fonksiyonel ses hastalıklarında ses rehabil- itasyonu ile elde edilen sonuçların değerlendirilmesi. [Uzmanlık Tezi] Ankara: Gülhane Askeri Tıp Akademisi; 2002.
• Campisi P, Tewfik TL, Pelland-Blais E, Husein M, Sadeghi N. MultiDimensional Voice Program analysis in children with vocal cord nodules. J Otolaryngol 2000; 29:302-8.
• Kılıç MA. Puberfoni ve tedavisi. KBB İhtisas Dergisi 2000;7:145-8.
• Sataloff RT, Spiegel JR, Carroll LM, Darby KS, Rulnick RK. Objective measures of voice function. Ear Nose Throat J 1987;66:307-12.
• Hirano M, Hibi S, Yoshida T, Hirade Y, Kasuya H, Kikuchi Y. Acoustic analysis of pathological voice. Some results of clinical application. Acta Otolaryngol 1988;105:432-8.
• Boyanov B, Hadjitodorov S. Acoustic analysis of patho- logical voices. A voice analysis system for the screen- ing of laryngeal diseases. IEEE Eng Med Biol Mag 1997;16:74-82.
• Bhuta T, Patrick L, Garnett JD. Perceptual evaluation of voice quality and its correlation with acoustic mea- surements. J Voice 2004;18:299-304.
• Bridger MW, Epstein R. Functional voice disorders. A review of 109 patients. J Laryngol Otol 1983;97:1145-8.
• Multi-Dimensional Voice Program (MDVP). Operations manual. Lincoln. Park, NJ: Kay Elemetrics Corporation; 1993.
• Carding PN, Horsley IA, Docherty GJ. A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice 1999; 13:72-104.
• MacKenzie K, Millar A, Wilson JA, Sellars C, Deary IJ. Is voice therapy an effective treatment for dysphonia? A randomised controlled trial. BMJ 2001;323:658-61.
• Roy N, Gray SD, Simon M, Dove H, Corbin-Lewis K, Stemple JC. An evaluation of the effects of two treat- ment approaches for teachers with voice disorders: a prospective randomized clinical trial. J Speech Lang Hear Res 2001;44:286-96.
• Dunnet CP, MacKenzie K, Sellars GC, Robinson K, Wilson JA. Voice therapy for dysphonia - still more art than science? Eur J Disord Commun 1997;32(3 Spec No): 333-43.
• Öğüt F, Kılıç M.A. Disfoniler. In: Koç C, editör. Kulak burun boğaz hastalıkları ve baş boyun cerrahisi. Ankara: Ekin Yay; 2003. s. 1169-81.
• Fex B, Fex S, Shiromoto O, Hirano M. Acoustic analy- sis of functional dysphonia: before and after voice therapy (accent method). J Voice 1994;8:163-7.
• Munoz J, Mendoza E, Fresneda MD, Carballo G, Lopez P. Acoustic and perceptual indicators of normal and pathological voice. Folia Phoniatr Logop 2003;55:102-14.
• Hegde MN. Clinical research in communicative disor- ders. 2nd ed. Austin: Pro-Ed; 1994.
• Özdamar K. Modern bilimsel araştırma yöntemleri. Eskişehir: Kaan Kitabevi; 2003.
• Casper JK, Murry T. Voice therapy methods in dyspho- nia. Otolaryngol Clin North Am 2000;33:983-1002.
• Prater RJ. Voice therapy. Techniques and applications. Otolaryngol Clin North Am 1991;24:1075-92.
• Koçak İ. Model of laryngeal resonance and its use in improving voice quality through surgery. [Uzmanlık Tezi] İstanbul: Boğaziçi Üniversitesi; 2002.