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J Korean Soc Laryngol Phoniatr Logop > Volume 28(2); 2017 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2017;28(2): 100-105.
doi: https://doi.org/10.22469/jkslp.2017.28.2.100
스펙트로그램을 이용한 내전형 연축성 발성 장애와 근긴장성 발성 장애의 감별
노승호, 김소연, 조재경, 이상혁, 진성민
성균관대학교 의과대학 강북삼성병원 이비인후과학교실
Differentiation of Adductor-Type Spasmodic Dysphonia from Muscle Tension Dysphonia Using Spectrogram
Seung Ho Noh, So Yean Kim, Jae Kyung Cho, Sang Hyuk Lee, Sung Min Jin
Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Sang Hyuk Lee ,Tel: (02) 2001-2269, Fax: (02) 2001-2273, Email: entlsh@hanmail.net
Received: 31 October 2017; Revised: November 13, 2017   Accepted: 25 November 2017.  Published online: 31 December 2017.
Background and Objectives
Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD.
Materials and Methods
From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise.
Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups.
The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.
KEY WORDS: Adductor-type spasmodic dysphoniaMuscle tension dysphoniaSpectrogramVoice analysisDifferential diagnosis.
중심 단어: 스펙트로그램근긴장성 발성 장애연축성 발성 장애.
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