嗓音客观评估的研究进展

嗓音是一个复杂的多维现象,它是通过肺气流驱动声带振动继而被听者感知到的声音。嗓音疾病最早依靠富有经验的喉科医生的主观判断,由于受临床经验、个人习惯等一些主观因素的影响,难免出现误诊、漏诊。后来出现了嗓音的客观检测方法,随着现代计算机技术、电子技术的飞速发展,催生了一系列新的嗓音检测手段,计算机仿生功能检     

嗓音病患者激光术后的嗓音康复训练

目的探讨发声训练在嗓音病患者显微激光手术后嗓音康复中的作用。方法将60例嗓音病行显微激光手术后患者随机分为训练组和常规组各30例,两组患者均按嗓音外科显微激光术后常规治疗与护理;训练组另予发声训练,包括放松训练、呼吸训练、基础发声训练、咀嚼发声训练和变调发声训练,并注意训练步骤。结果两组术后3个月主观评估和客观评估指标比较,差异有统计学意义(均P<0.01)。结论发声训练能显著改善嗓音病患者术后嗓音质量,促进康复。     

Estimating subglottal pressure using incomplete airflow interruption

OBJECTIVE/HYPOTHESIS: Subglottal pressure (SGP) measurements are often used to assess laryngeal function; however, current methods to measure SGP are invasive or do not estimate SGP during phonation. The purpose of this study was to devise a noninvasive technique to estimate SGP without interrupting phonation. STUDY DESIGN: This was a methodologic study designed to calculate the SGP of a human subject. METHODS: A new technique to estimate SGP was developed in which subject airflow was partially interrupted by introducing two different impedances (pneumatic resistors) through a balloon valve controlled mouthpiece. The changes in airflow across varying impedances were used to estimate SGP in human subjects based on the predictable relationships between SGP, impedance, and airflow measurements. The technique was used to assess eight human subjects (age 19-30) phonating at intensities of 65, 72, and 80 dB. RESULTS: The estimated SGP from the human subjects fell within a range (5.52-8.91 cm H20) that was consistent with previous studies. As other studies have found, SGP estimations significantly increased as subjects phonated at greater intensities (P < .01). Intrasubject standard deviations compared favorably with those from previous studies of complete airflow interruption, suggesting satisfactory reliability. The technique was validated using a mechanical "pseudolung" device (r = 0.9982). CONCLUSIONS: Incomplete airflow interruption offers the potential for useful clinical application to assess the severity of vocal pathology by estimating SGP during continuous phonation.     

声带息肉的显微手术治疗及嗓音评估

目的：分析声带息肉显微声带缝合术后的嗓音改善情况。方法对33例广基声带息肉患者行支撑喉镜手术，用8-0可吸收线对术中形成的较大黏膜缺损或残留正常黏膜瓣缝合并固定。术前、术后2周、1月行总嘶哑度、粗糙度、气息度、听觉感知评估（GRABS）评分及客观嗓音分析。结果术后2周与术前相比，无论是听觉感知评估还是客观各项声学参数检测均有明显改善，差异均有统计学意义（t分别=5.51、3.87、4.87、6.56、5.34、8.66，P均＜0.05）。术后2周时声带稍充血，声带振动幅度及黏膜波轻度减轻。术后1月声带形态恢复正常，且声带振动和黏膜波的传播恢复。术后1月与术后2周相比，频率微扰和振幅微扰较前改善，差异均有统计学意义（t分别=2.97、4.54， P均＜0.05），余各项声学参数比较，差异均无统计学意义（t分别=1.73、1.46、1.01、1.62，P均＞0.05）。结论支撑喉镜下显微缝合技术可促进声带息肉术后嗓音恢复，改善嗓音质量。