Stroboscopy is very useful for clinical evaluation of abnormality in the mode of vocal cord vibration. With good trained eyes. one can detect changes in physical parameters of histological changes in the vocal cord to a certain extent.

Stroboscopic examination was performed on 149 cases who complained of voice disorders at the Department. of Otolarynglogy of Ewha Womans university hospital recently and the following results were obtained.

1) The underlying diseases in order frequency were vocal nodule and polyp 67cases(45%). acute and chronic laryngitis 32cases(22%), benign tumor l6cases(l1%), vocal cord paralysis 15cases(10%), sulcus vocalis 8cases(5%), laryngeal cancer 6cases(4%), epithelial hyperplasia 5cases(3%).

2) Glottic closure in pathological cases were as that follows ; Among l49cases, incomplete closure were 112cases(75%) and complete closure were 37cases(25%).

3) Regularity of vibration in pathological cases were as that follows ; Among l49cases. irregular were 82cases(55%) and regular were 67cases(45%).

4) Symmetry of vibratory movements of vocal cords in pathological cases were as that follows ; Among l49cases. asymmety were 69cases(46%) and symmetry were 80cases(45%).

5) Amplitude of vibration in pathological cases were as that follows ; Among l49cases. normal were 62cases(42%), great were 8cases(5%), small were 74cases(50%) and zero were 5cases(3%).

6) Wave on the mucosa in pathological cases were as that follows ; Among l49cases. normal were 62cases(42%), great were 62cases(1%), small were 2cases(42%) and zero were 23cases(15%).

A clinical study of correct diagnosis by auscultation of voice was performed on 150 cases who complained of voice disorder at the Dept. of Otolarynglolgy of Ewha Womans university hospital recently and the following results were obtained.

1) The underlying diseases causing voice disorder in order of frequency were as that follows ; vocal polyp and nodule were 58 cases(38.6%), recurrent nerve paralysis were 26 cases(17.3%), laryngitis were 16 cases(10.7%), laryngeal cancer were 12 cases(8.0%).

2) Among total of 150 cases, male were 74 cases and female were 76 cases. Among 58 cases of vocal polyp and nodule, male were 22 cases(37.9%) and female were 36 cases(62.1%). Among 26 cases of recurrent nerve paralysis, male were 16 cases(61.5%) and female were 10 cases(38.5%). Among 16 cases of laryngitis, male were 6 cases(37.5%) and female were 10 cases(62.5%). Among 12 cases of laryngeal cancer, male were 8 cases (66.7%) and female were 4 cases (33.3%). Among 6 cases of mutation disorder, male were 6 cases(100%), Among 4 cases of anabolic steroid dysphonia, female were 4 cases (100%).

3) Results of auscultation of voice were as that follows ; The highest incidence of voice quality of vocal polyp and nodule in order frequency were BR factor(55.2%) and R factor(30.8%). Recurrent nerve paralysis in order frequency were AB factor(46.2%) and BR factor(30.8%). Laryngitis in order frequency were BR factor(43.8%) and R factor(31.3%). Laryngeal cancer in order frequency were BR factor(83.8%) and R factor(8.3%).

4) The rate of correct diagnosis by auscultation of voice were as that follows ; Correct diagnosis were 69%. Correct diagnosis inclued binary choice and correct diagnosis were 78%. Wrong diagnosis indicating similar pathlolgical conditions, correct diagnosis and correct diagnosis inclued in binary choice were 81%.

This report provides information on the phonational frequency range and alternation of registration of male university students. Phonational frequency range is defined as that range of vocal frequencies encompassing both the chest and head voice registers.

The purpose of this study is, by understanding of voice essence and observation of changeable condition by acquired factors.

The results of comparative analysis between professional voice users(students of singing school) as study group and non-professional voice users as control group are as follows.

1) The phonational frequency range of study group is 22~38 semitones and that of control group is 20~34 semitones. There is 2~4 semitones difference between study and control group.

2) According to the average phonational frequency range of each grade, there is no significant difference in the study group but there is increasement of 1 semitones per each grade in phonational frequency range.

3) The persons who have longer voice training duration have more high phonational frequency range than who have shorter voice training duration.

4) Both control and study groups show that higher grades have higher phonational frequency range.

5) The alternation of the registrations are higher in the study group than in the control group, but in the study group the alternation of the registration is obscure.

A clinico-statistical analysis was performed on 35 cases of mutational disturbance at Dept. of Otolaryngology of Ewha Womans University Hospital during past 5 years and the following results were obtained.

1) Among 35 cases of mutational disturbance, continuation of mutational disturbance were 11 cases, 9 cases were male(25.7%) and 2 cases were female(5.7%).

2) Among 15 cases of phonasthenia, 5 cases were male(14.3%) and 10 cases were female(28.6%).

3) Among 9 cases of vocal cord atrophy, 6 cases were male(17.1%) and 3 cases were female(8.6%).

4) The age distribution of mutational disturbance in order of frequency were obtained as follows. Among 11 cases of continuation of mutational disturbance, 21~ 25year old group were 5 cases(45.5%), 15-20 and 31~35year old group were 2 cases(18.2%) each. Among 15 cases of phonasthenia, 26~30year old group were 6 cases(40.0%), 31~35year old group were 3 cases(20.0%). Among 9 cases of vocal cord atrophy, 26~30year old group and 31~35year old group were 2 cases(33.3%) each.

5) Duration of visit after voice disturbance in order of frequency were 1~2year group 10 cases(28.6%), 3~5year group 9 cases(25.7%) and 6month~lyear group 4 cases(11.4%).

6) Other symptoms except voice disorder in order of frequency were dry sensation of pharyngolarynx, foreign body sensation of pharyngolarynx, neurasthenia, general fatigue, pain of neck and shoulder area.

A clinico-statistical analysis was performed on 389 cases of professional voice users who complained to voice disorder at dept. of otolaryngology of Ewha Womans University Hospital during past 10 years from Jan. 1975 to Dec. 1984 and the following results were obtained. 1) Among total of 44,912 who visited the dept. of otolarfyngology, the patients with voice disorders were 1373 cases (3.1%). 2) Among total 1016 cases, male were 586 and female were 787, the ratio being 1:1.3. 3) Among total of 1016 cases, 389 were cases of professional voice users(38.3%) 4) The occupational distribution of professional voice users with voice disorder in order of frequency were acute laryngitis 125 cases (32.1%), chronic laryngitis 67 cases(17.2%), vocal nodule and polyp 155 cases (39.9%), phonasthenia 15 cases (3.9%), laryngeal neurosis 16 cases (4.1%), vocal muscle paralysis 11 cases(2.8%). 5) Among 125 cases of acute laryngitis, vocal musicians were 63 cases (50.4%), Korean classical musicians were 20 cases (16.0%), teachers were 16 cases(12.8%), pastors were 9 cases (7.2%), drama players were 6 cases (4.8%), radio actors were 7 cases(5.6%), announcers were 4 cases (3.2%). 6) Among 67 cases of chronic laryngitis, vocal musicians were 19 cases(28.4%), Korean classical musicians were 15 cases(22.4%), teachers were 19 cases(28.4%), pastors were 6 cases(9.0%), drama players were 4 cases(6.0%), radio actors were 2 cases(2.9%), announcers were 2 cases(2.9%). 7) Among 155 cases of vocal nodule and polyp, vocal musicians were 45 cases(29.1%), Korean classical musicians were 23 cases (14.8%), teachers were 61 cases (39.4%), pastors were 13 cases(8.4%), drama players were 7 cases(4.5%), radio actors were 5 cases(3.2%), announcer was 1case(0.6%). 8) Among 15 cases of phonasthenia, vocal musicians were 6 cases (40.0%), teachers were 6 cases (40.0%), Korean classical musician, announcer and pastor were each 1 case(20.0%). 9) Among 16 cases of laryngeal neurosis, drama players were 6 cases(37.5%), vocal musicians were 5 cases(31.3%), teachers were 4 cases(25.0%), announcer was 1 case(6.2%). 10) Among 11 cases of vocal muscle paralysis, teachers were 6 cases(54.5%), pastors were 2 cases (18.2%), vocal musician, Korean classical musician and drama player were each 1 case(27.3%).

A clinico-statistical analysis was performed on 1373 cases who complained of hoarseness at the dept. of Otolaryngology of Ewha Womans University hospital during the past 10 years from Jan. 1975 to Dec. 1984 and the following results were obtained. 1) Among total of 44,912 who visited the dept. of Otolaryngology, the patients with hoarseness were 1373 cases(3.1%). 2) Among total of 1373 cases, male were 585 and female were 787, the ratio being 1:1.3. 3) The underlying diseases causing hoarseness in order frequency were acute laryngitis 374 cases(27.2%), chronic laryngitis 325 cases(23.7%), vocal nodule 248 cases(18.1%), vocal polyp 130 cases(9.5%), vocal cord paralysis 101 cases(7.4%), laryngeal cancer 24 cases(1.7%). 4) The highest incidence of age causing hoarseness in order frequency were 3rd decade 368 cases(26.8%), 2nd decade 312(22.7%), 4th decade 297 cases(21.6%). 5) The highest incidence of age for underlying diseases in order of frequency were as that follows: acute laryngitis in 2nd decade 114 cases(30.5%), chronic laryngitis in 3rd decade 92 cases(28.3%), vocal nodule in 3rd decade 81 cases(32.7%), vocal polyp in 4th decade 38 cases(29.2%), vocal cord paralysis in 5th decade 19 cases(18.8%), laryngeal cancer in 5th decade 13 cases(54.2%). 6) Number of the patients who came the hospital within 10 days after the onset of hoarseness were 272 cases(19.8%), 15 cases(1.1%) had medical attention for first time 10 years after hoarseness. 7) The highest incidence of the duration from the onset to consultation for the underlying diseases were as that follows: acute laryngitis within 10 days 205 cases(54.8%), chronic laryngitis 3M-6M 76 cases (23.4%), vocal nodule 3M-6M 55 cases(22.2%), vocal polyp 6M-1 Yr 32 cases(24.6%), vocal cord paralysis 3M-6M 20 cases(19.8%).

In the view point of singing voice, the determining of the proper voice position is very important. It is also very important to establish the correct method of voice use with proper voice position. The purpose of this study is, by understanding of voice essence, to provide the guidance of correct use and the prevention of voice disorders of professional voice users. Following result were obtained. It were classified in 4 group as follows. 1) Group 1 ; The opinions of the student and teacher correspond with the laryngoscopic pictures. There were 11 males(15.7%) and 27 females(38.6%) in the group 1. 2) Group 2 ; The opinions of the student correspond with the teacher's opinion but not correspond with laryngoscopic pictures. There were 6 males(8.6%) and 7 females(10.0%) in the group 2. 3) Group 3 ; The opinions of the student not correspond with the teacher's opinion and laryngoscopic pictures. There were 5 males(7.1%) and 6 females(8.6%) in the group 3. 4) Group 4 ; The opinions of student correspond with laryngoscopic pictures but not correspond with the teacher's opinion. There were 3 males(4.3%) and 5 females(7.1%) in the group 4.

Sudden hearing loss is an accepted abbreviation for the more complete term, idiopathic sudden sensorineural hearing loss. Numerous definitions of this entity have been offered. It is distinguished from other forms of sensorineural hearing loss by the rapidity of its onset, which may be within a moment or over a few days. The treatment of idiopathic sudden sensorineural hearing loss is treatment of symptom, not a disease, for which no specific causes are definitely known. A clinico-statistical survey was performed on 39 cases of idiopathic sensorine-ural hearing loss at the department of Otolayngology, Ewha Womans University during the past 6 years from January 1978 to August 1984. The results were as follows: 1) The occupation of the patients are employee of a company (38.5%), commerce(17.9%), house wife(15.4%), no occupation(15.4%), police man(7.7%) and soldier(5.1%). 2) Among configuration of the initial pure tone audiometry, profound high tone loss was found in 35.8%, severe hearing loss in 25.6%, moderate severe hearing loss in 20.5%, moderate hearing loss in 12.8%, mild hearing loss in 5.1%. 3) On the combined symptoms with sudden hearing loss, there was tinnitus in 46.2%, vertigo in 20.5%, tinnitus with vertigo in 17.9%, headache in 15.4%. 4) On the combined other diseases with sudden hearing loss, there was hype-rtension in 28.6%, diabetes mellits in 19.0%, allergy in 19.0%, Influenza in 14.4%, arteriosclerosis in 9.5%, psychogenic deafness in 9.5%. 5) On the possible etiologic factors, 15.4% of them were hypertension, viral disease in 12.8%, diabetes mellitus in 10.3%, allergy in 10.3% and unknown origin in 15.4%. 6) Early treatment with low salt diet and bed rest had favorable results. 7) Our treatment method of In-patient were as follows : a) The patient was hospitalized for at least 3 days. b) Nicotinic acid in a flushing dose(50-300mg) given before meals and at bed time until hearing stabilized for at least 3 weeks. c) 10% Dextran, 500cc every 12 hours for 3 days. d) Prednisolon, 10mg 3 times daily for 10 days then given in reduced amount to zero over 10 days. e) Benadryl, 50mg 4 times daily orally or by injection until the hearing stabili-zed for at least 3 weeks. Treatment method of Out-patient : a) Absolute bed rest for 1 week and avoid every stimuli. b) Nicotinic acid therapy, prednisolon therapy and benadyl therapy were given as in-patient method. c) Ascorbic acid, ATP, thiamine hydrochloride were given. d) Low salt diet.

Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration.

This is the site of predilection for vocal cord nodules.

The author performed laryngomicrosurgery for 50 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 3 years.

The results obtained were as follows:

1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy.

2) In children, surgery is rarely indicated because most nodules in children regress during adolescence.

3) For patients who use their voices professionally, voice therapy is indicated for three months.

4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered.

5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position.

6) Removal of the nodule should be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule.

7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch.

8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.

Early detection of deafness is of paramount important for the success of rehabilitation of the deaf child. In asmuch as complete deafness in usually not detected until the second year of life, it seems to be reasonable that the test for hearing should be made as a part of the physical examination in the newborn nursery. It is possible that such routine test in nursery could give an accurate statistical data regarding to the incidence of true congenital deafness at an early age. The purpose of this investigation is to detect the deafness as early as possible in order to treat properly. This paper represents the findings of a study investigated auditory responses of 100 neonates by Beltone Audiometer Model 15 CX, who are delivered normally at Ewha Womans University Hospital. The results are as follows: 1. The response according to the sound stimulation was 79 cases among 100 cases(79%). 2. The degree of intensity in response revealed strong response(41%), weak but clear response(29%), obscured response(13%), paroxysmal response(9%), and non-response(8%). 3. The relation between infant state and response rate revealed 90.0% neonates in light sleep, 78.7% in awake and 46.2% in deep sleep. 4. Response rate according to the age showed 71.4% of 1 day, 86.1% of 2 days, 83.3% of 3 days, 80.0% of 4 days and 100.0% of 5 days. 5. Simple response was 69.6% and combined response was 30.4% and auditory response of neonates was in 20 cases of cochleopalpebral reflex(18.3%), 19 cases of open eyelid or eyeball shift(17.3%), 13 cases of grimace(11.9%), 9 cases of Moro reflex(8.3%), 8 cases of movement(74%), 8 cases of sucking(7.4%), 7 cases of ceasing activity(6.4%) and 7 cases of deep respiration(6.4%). 6. Response rate was 79% when 3000Hz, 90dB was applied but it was 67% in 500Hz, 90dB. 7. When recheck was done 3 weeks later in obscured and non-response group, all showed positive auditory responses. In conclusion, the auditory response in neonatal period is greatly important, not only its incidence but early detection for the proper treatment. Therefore auther recommend the mass screening of hearing acuity among newborn infants in all nurseries as part of the routine neonatal evaluation.

In the cases with voice disorders, voice case history, special examinations and function tests for voice were required. The voice case history is necessary for obtain the etiology of the voice disorder as well as the factors contributing to the problem. This is important for diagnosis of voice disorders in addition to a general back ground of the patient's growth and development including speech and language. Among those tests, auscultation of voice is the most important for diagnosis of some types of voice disorders, such as hormonal disturbance, spastic dysphonia and so on. It is also helpful to promote further careful examinations for any voice disorders. Maxiumum phonation time and mean air flow rate during comfortable phonation with the air volume similar to tidal air is useful for rough evaluation of the laryngeal efficiency during modal speech. Stroboscopy is very useful for clinical evaluation of abnormality in the mode of vocal cord vibration and analysis of ultra high speed film is the best way to investigate vocal cord vibration in detail. Acoustical analysis of voice appears to be usable for a screening test with tape-recorded voice. Electromyography is greatly valuable for determining prognosis recurrent laryngeal nerve paralysis.

The localized vocal polyp and singer's nodules are the most common benign lesion of the larynx. This lesion is due mainly to trauma secondary to vocal abuse.

These nodules were ressected out with laryngeal forcep under indirect laryngoscopy and maximum phonation time was measured before and after the operation.

Timbre of the voice was also analyzed at same time.

Very shortened phonation time of the patient with vocal nodule has returned to normal range (male:30 seconds, female: 20 seconds) postoperatively.

Maximum phonation time has been widely utilized as a simple clinical test for evaluating the vocal function.

It is the purpose of this study to acknowledge how much the expiratory movement during the phonation is converted into a single vowel sound efficiently. The author has made a brief literature review.