OSAHS患者H-UPPP术后嗓音变化研究

目的探讨成人阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OS-AHS）患者行改良悬雍垂腭咽成形术（H-uvulopalatopharyngoplasty，H-UPPP）前后声道共鸣腔的变化对发音的影响。方法用美国Tiger公司的DrSpeech4．0软件，对56例成人OSAHS患者于H～UPPP手术前后，平稳自然的发／e／音，行嗓音声学参数及共振峰分析，并与40例正常对照组比较。结果除标准化噪声能量在手术前后有显著性差异外，OSAHS患者手术前后的其他嗓音声学参数均无统计学差异。OSAHS患者术前第一共振峰及带宽、第二共振峰及带宽、第三共振峰均明显低于正常；术后一周时的第一及第二共振峰均低于正常对照，但与术前无统计学差异；术后一月时的共振峰均与正常对照无显著性差异。结论H-UPPP手术通过解除OSAHS患者上气道的阻塞性因素及进行咽腔的塑形，改变声道共鸣腔，能够改变OSAHS患者的发声特点及音质，术后随时间的延长，共振峰频率逐渐增高，接近正常水平。

Voicing Changes of Adult Patients with Obstructive Sleep Apnea hypopnea Syndrome (OSAHS) after H- uvulopalatopharyngoplasty (H- UPPP)

Objective To investigate voicing changes of adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after H-uvulopalatopharyngoplasty (H-UPPP). Methods 56 adult OSAHS pa-tients and 40 healthy people were included in the study. Acoustic parameters and formant frequencies were measured for each patient before and after H- UPPP, and also for the control group. Results Acoustic parameters: each group demonstrated no differences in all the parameters except for normalized noised energy (NNE). NNE increased after H-UPPP. Formant frequency: F1, B1, F2, B2, F3 of OSAHS patients were significantly lower than normal control. There was no significant difference in the formant frequency before operation and one week after; however, F1 and F2 were lower than the normal control one week after surgery. One month after surgery, F1 and F2 were ob-viously higher than that obtained in one week. All the other parameters compared with normal controls showed no significant discrepancies. Conclusion Acoustic characteristics of adult OSAHS patients were different from healthy person. After H-UPPP, the vocal tracts of patients changed, thus causing improvement to the acoustic parameters and voicing qualities, especially at the formant frequency. After the surgery, the formant frequencies of the patients increased gradually to the range of healthy people.