变声期嗓音的声学特征分析

目的分析变声期各年龄段嗓音声学特点和差异。方法 1 028例变声期无嗓音疾病的青少年根据年龄分为三组,变声前期组(10～12岁)259例,男127例,女132例;变声中期组(13～16岁)467例,男234例,女233例,该组再分为A组(发声轻度沙哑、音调不稳定者,男66例,女70例)和B组(无明显发声沙哑、音调稳定者,男168例,女163例);变声后期组(17～20岁)302例,男122例,女180例。采用美国Kay公司多维嗓音分析软件,比较各组发长元音/α:/的基频(F0)、基频微扰(jitter)、振幅微扰(shimmer)、振幅扰动商(APQ)、噪/谐比(NHR)。结果各年龄段男女间F0差异均有统计学意义(P<0.05),F0的正常参考值:变声前期男性为270.90±27.39,女性为287.54±25.51;变声中期A组男197.74±43.09,女259.54±25.99;B组男178.38±46.75,女254.91±22.24;变声后期男148.97±25.08,女255.45±25.01。除A组外,其余组Jitt值女性均高于男性(P<0.05),变声中期组中同性别NHR值A组高于B组(P<0.05)。结论从变声前期开始嗓音F0即出现性别差异,均为女性高于男性;NHR无性别差异,但可作为衡量变声中期嗓音质量的重要指标。     

重度感音神经性聋儿童的多维嗓音分析

目的 分析不同性别正常儿童及重度感音神经性聋儿童嗓音的声学特点和差异.方法 以130例6～12岁无嗓音相关疾病的正常儿童(男65例,女65例)为正常组;以71例6～12岁先天性重度至极重度感音神经性聋儿童(男34例,女37例)为耳聋组;采用美国Kay公司的计算机多维嗓音分析软件MDVP,比较各组儿童发长元音/a:/的基频(F0)、基频微扰(jitter)、振幅微扰(shimmer)、基频变量(vF0)、峰值振幅变量(yAm)、振幅扰动商(APQ)、噪/谐比(NHR).结果 正常组儿童不同性别间各指标值差异均无统计学意义(均为P＞0.05);耳聋组vF0、vAm分别为2.61％±1.15％和23.57％±8.29％,显著高于正常组(1.77％±1.01％和16.31％±7.75％)(P＜0.01).两组F0、jitter、shimmer、APQ、NHR差异均无统计学意义(均为P＞0.05).结论 6～12岁正常儿童的嗓音客观声学分析无性别差异,重度及以上听力损失患儿在持续平稳发声时不能对代表长时频率变化的基频变量(vF0)和长时振幅变化的峰值振幅变量(vAm)有良好的控制能力,vF0和vAm可作为评估人工耳蜗植入术后其嗓音和言语能力有无提高的参考指标.     

正常成人嗓音频谱分析

为探讨不同性别及不同年龄阶段我国正常成人嗓音的声学特征,应用计算机频谱分析技术对145例18～80岁正常人的嗓音进行声学参数检测.结果表明:各年龄段男女基频(F_0),第二、三共振峰(F_2、F_3),频率微扰商(FPQ)以及中、青年男女间振幅微扰商(APQ)有显著性差异,男性振幅微扰商(APQ)随年龄增长而下降,六十岁以后又明显升高,老年男性基频(F_0)明显升高而老年女性基频(F_0)则明显下降.本研究可为临床嗓音的分析评估提供客观的方法和依据.     

不同噪声环境中嗓音声谱特点

目的探讨两种噪声环境下嗓音的声谱图特点。方法选择健康青年25人，进行一定训练后，分别在安静环境、白噪声环境、语音环境下进行录音；录音内容包括持续元音／a／i/；用Doctor Speech软件分析，对基频、共振峰进行比较。结果男性／a／音、女性／a／音、女性／i／音基频在噪声环境下明显提高；男性／a／音、男性，i／音、女性／i／音，第一共振峰(F1)在噪声环境下明显提高。结论噪声环境可影响正常人嗓音的基频、共振峰。     

男声女调患者与正常男性嗓音参数的对比分析及临床意义

目的探讨男声女调患者嗓音参数与正常男性嗓音参数的区别,为临床诊疗提供参考依据。方法收集30例男声女调及30例正常男性的动态喉镜及嗓音资料,对比分析其嗓音参数。结果26例（86.67%）男声女调患者动态喉镜下表现为声门闭合不全。男声女调患者发音时的基频(F0)为（243.3±42.1）Hz,显著高于正常人的（146.2±25.4）Hz(P<0.01);男声女调患者及正常人发音时的响度分别为（80.0±8.3）dBA、（82.2±9.1）dBA,两者经比较无统计学意义(P>0.05);男声女调患者发音时的振幅微扰(shimmer)为(2.6±1.4)%,与正常人的(1.9±0.7)%比较无统计学意义(P>0.05);男声女调患者及正常人发音时的基频微扰(jitter)均值分别为(0.5±0.2)%、(0.6±0.2)%,两者经比较无统计学意义(P>0.05);男声女调患者的嗓音障碍指数(voice handicap index,VHI)为-0.5±1.6,显著低于正常人的3.8±1.6(P<0.01);男声女调患者的最长发音时间(maxmum phonation time,MPT)为（16.0±7.5）s,较正常人的（32.0±4.9）s显著缩短(P<0.01);音域（range）测量男声女调患者为（288.4±140.8）Hz,显著小于正常人的（611.1±226.1）Hz(P<0.01)。结论大部分男声女调患者存在声门闭合不全。男声女调患者发音时的基频高于正常人,嗓音障碍指数低于正常人,最长发音时间较正常人缩短,音域较正常人变窄,而响度、振幅及基频微扰值与正常人相比无显著差异。     

单侧声带小息肉患者术后声休时间对嗓音功能的影响

目的 探讨单侧声带小息肉患者术后声休时间对嗓音功能的影响。方法 筛选山西医科大学第一医院耳鼻咽喉头颈外科住院部中拟行单侧声带小息肉手术的患者120例,术前予以嗓音卫生宣教,指导患者发声方法训练,并完善相关嗓音声学分析,包括基频微扰(Jitter)、振幅微扰(Shimmer)、最长发声时间(MPT)、嗓音障碍严重指数(DSI)、粗糙声/气息声/嘶哑声(RBH)、嗓音障碍指数量表(VHI)等,所有患者术前各嗓音声学参数差异均无统计学意义(P>0.05)。术后采用随机抽样法将患者分为3组,每组各40例。3组患者在常规治疗(健康教育、手术治疗、药物治疗)的基础上术后行绝对声休,其中A组术后声休3 d, B组术后声休7 d, C组术后声休2周;各组患者声休结束后予以8周的嗓音训练。术后3、6个月复查时对各组患者行嗓音声学分析,分析各组间嗓音声学参数的差异性,并与术前各嗓音声学参数进行对比。结果 (1)术后3、6个月,各分组嗓音训练后Jitter、Shimmer、VHI、RBH均明显下降,MPT、DSI明显上升,与术前相比差异具有统计学意义(P<0.05);(2)术后3个月,A组和B组...     

声带息肉患者的嗓音声学分析与VHI的相关性研究

目的 探讨嗓音声学分析与嗓音障碍指数(voice handicap index,VHI)用于嗓音质量评估的临床意义及其相关性,并进一步验证VHl的实用性.方法 对35名声带息肉患者(患者组)及35名嗓音正常人(对照组)进行嗓音声学分析和VHI调查,嗓音声学分析指标包括振幅扰动商(amptitude perturbation quotient,APQ)、基频微扰(jitter)、振幅微扰(shimmer)、噪/谐比(NHR),VHI调查包括功能(F)、生理(P)、情感(E)三个范畴,记录三方面得分及总分(TVH)分值.结果患者组的APQ、jitter、shimmer、NHR均高于正常组,差异有统计学意义(P<0.05);患者组VHI的TVH平均值为43.32±4.66分,而正常组的平均值为12.51±1.88分,两组间差异有统计学意义(P<0.05).声带息肉患者嗓音声学分析参数与VHI之间无显著相关性.结论 临床上不能以嗓音声学分析为标准来判断或推测声带息肉患者症状轻重;VHI可主观反映患者嗓音障碍程度.     

内收型痉挛性发音障碍患者动态喉镜表现及嗓音学特点

目的探讨内收型痉挛性发音障碍（SD）患者的动态喉镜下表现、嗓音学特点以及病因,并与正常人对比分析,为临床诊断及进一步治疗提供参考依据。方法收集61例内收型SD患者的嗓音参数以及30例正常对照者的嗓音参数,对比分析。结果61例患者中51例为女性患者;61例患者中35例（57.4%）患者的反流体征评分量表（RFS）的分值>7;有明显心理因素或心理创伤的患者7例（11.5%）。患者发音时存在一些颈部及全身肌肉过度紧张的表现,动态喉镜下所有患者均无器质性病变,主要表现为双侧声带紧张并过度内收、喉部震颤,部分患者可见声门上结构向中间挤压靠拢。嗓音测试时所有患者在朗读过程中存在紧张性发音,基频(F0)及响度瞬间起伏,语音颤抖、嗓音挤卡、失去韵律,42例（68.9%）患者出现嗓音中断：患者读一段话的嗓音平均中断次数（1.9±2.0）次显著高于正常人（0.0±0.0）次（P<0.01）;所有患者读一段话的朗读时间均值（21.5±4.8）s较常对照组的朗读时间均值（16.2±3.7）s显著延长,差异具有统计学意义(P<0.01);患者的振幅微扰(shimmer)均值及基频微扰(jitter)均值为显著高于正常对照组 (P<0.01);患者的嗓音障碍指数(DSI)均值显著低于正常对照组 (P<0.05);患者的最长发音时间(MPT)较正常对照组显著缩短(P<0.01)。结论内收型SD患者大部分为女性,患者动态喉镜下会有一些特征性表现,患者的音质、音韵和流畅性较正常人有一定改变;患者的shimmer、jitter、DSI、MPT较正常人有显著差异。该疾病可能与胃酸反流有一定关系,少部分患者可能存在心理因素。     

单侧声带息肉患者喉显微手术后嗓音特征的动态观察

目的 通过分析单侧声带息肉患者喉显微手术后不同阶段的嗓音变化规律及形态学转归特点,探讨声带息肉术后早期禁声及后期声休最佳时间.方法 对30例非广基单侧声带息肉患者于喉显微手术前和手术后1、2、3、4周行纤维喉镜检查,进行声带形态学评估,同时以CSL model4150(美国Kay Elemetrics)行嗓音声学分析,以60例(男女各30例)嗓音正常成年人作为对照组.结果 术后第1周63.33%(19/30)患者术侧声带轻度充血,边缘齐,声门闭合良好;术后第2周86.67%(26/30)患者术侧声带充血水肿消退,外观基本正常.术后1周声带息肉组的基频微扰百分比(jitter percent,jitt)、基频扰动商(PPQ)、振幅微扰百分比(shimmer percent,shim)、振幅扰动商(APQ)、噪/谐比(NHR)测试结果与术前比较差异无统计学意义(P＞0.05),明显高于对照组(P＜0.01);术后2～3周jitt、PPQ值较术前降低(P＜0.05),但仍高于对照组(P＜0.05),而shim、PPQ、NHR值与术前比较差异无统计学意义(P＞0.05),仍明显高于对照组(P＜0.01);术后第4周jitt、PPQ值与术前比较明显降低(P＜0.01),shim、APQ、NHR值与术前比较亦减小(P＜0.05),jitt、PPQ、shim、APQ、NHR值与对照组比较差异无统计学意义(P＞0.05).结论 非广基单侧声带息肉患者术后声带外观恢复正常至少需2周;而发声功能恢复正常水平至少需1个月.建议声带息肉患者术后严格声休2周;术后2周至术后1个月为相对声休期.     

喉全切除后食管音助发声器发音的客观声学分析

目的通过客观声学分析了解喉全切除术后食管音助发声器发音的发音质量。方法应用上海泰亿格公司的Dr.speed嗓音声学分析软件对7例食管音助发声器发音的患者(食管音助发声器发音组)及5例气管食管音患者(气管食管音组)的基频、基频微扰、振幅微扰、谐噪比、声强及最大发声时间进行检测,并与12名正常男性(对照组)进行比较。结果食管音助发声器发音组、气管食管音组的基频、基频微扰、振幅微扰、谐噪比,最大发声时间与对照组比较差异有统计学意义(P<0.05或P<0.01),三组间声强比较差异无统计学意义(P>0.05),食管音助发声器发音组最大发声时间比气管食管音组长(P<0.05),其余指标与气管食管音组比较差异无统计学意义(P>0.05)。结论食管音助发声器发音的声音的声强可达77.40 dB、最大发声时间可达10.77秒,基本能够满足日常交流的需要。     

Acoustic analysis of tracheoesophageal speech in comparison to esophageal speech after total laryngectomy

In order to evaluate the vocal quality of tracheo-oesophageal (TE) and oesophageal (E) speech, several acoustic parameters were measured in the acoustic waveform (fundamental frequency, maximum phonation time, maximum intensity) and in the frequency spectrum: harmonicity-to-noise ratio [HNR], pitch perturbation [Jitter], Shimmer. Thirteen patients using tracheo-oesophageal speech (Provox 2 valve) and 11 good oesophageal speakers were evaluated. The control group consisted of 10 healthy men with normal speech. Digital recordings were obtained from examined subjects as they sustained the vowel "a". Maximum phonation time in TE samples was significantly longer than in E speech recordings and similar to the normal speech. The tracheo-oesophageal voices more often showed a detectable fundamental frequency which was fairly stable and lower than in oesophageal and normal speech. In our cohort of patients maximum voice intensity in both groups of alaryngeal speakers was similar and lower than in control group. The Jitter and Shimmer results of TE speech were similar to those of E speech and higher than in controls. HNR was significantly higher in TE speech than in E voice and three times lower in comparison to normal speech. The results of this investigation indicate that TE speech is more like normal speech than is E voice.     

假声发声气流率及口腔压力的观察

对１０例（２０个声样）２６－４５岁健康人分别以胸声及假声发持续性元音“ｉ”及重复性章节“Ｐｉ”进行了纤维喉镜及气流动力学检查。结果表明：（１）假地声门闭合程度较胸声明显降低；（２）假声时气流率罗胸声时高，这与假声门闭合降低有关；（３）当胸声转为假声时，口腔压力升高，这可能与增加声带张力及维持声带振动频率有关。     

Ⅰ型甲状软骨成形术治疗单侧声带麻痹的嗓音学分析

目的 探讨Ⅰ型甲状软骨成形术治疗单侧声带麻痹的嗓音学特征.方法 应用美国Kay公司的MDVP 5105软件对16例单侧声带麻痹患者手术前、后嗓音声学参数进行分析.结果 16例(100％)患者声学参数基频、频率微扰、振幅微扰及最长声时平均值与术前明显改善(P＜0.050,主观感觉满意.结论 Ⅰ型甲状软骨成形术对改善单侧声...     

Cepstral peak prominence: a more reliable measure of dysphonia

Quantification of perceptual voice characteristics allows the assessment of voice changes. Acoustic measures of jitter, shimmer, and noise-to-harmonic ratio (NHR) are often unreliable. Measures of cepstral peak prominence (CPP) may be more reliable predictors of dysphonia. Trained listeners analyzed voice samples from 281 patients. The NHR, amplitude perturbation quotient, smoothed pitch perturbation quotient, percent jitter, and CPP were obtained from sustained vowel phonation, and the CPP was obtained from running speech. For the first time, normal and abnormal values of CPP were defined, and they were compared with other acoustic measures used to predict dysphonia. The CPP for running speech is a good predictor and a more reliable measure of dysphonia than are acoustic measures of jitter, shimmer, and NHR.     

声带息肉围手术期嗓音训练的临床疗效分析

目的　探讨声带息肉患者围手术期行嗓音训练对嗓音恢复的临床疗效。方法　选取72例于我院耳鼻咽喉科行声带息肉手术的患者,随机均分为研究组和对照组,术后对照组仅接受常规治疗,研究组在常规治疗的基础上进行嗓音训练,比较两组患者术后8周的嗓音声学分析结果。结果　术后8周研究组在最长发声时间（maximum phonation time,MPT）、嗓音障碍严重指数（dysphonia severity index,DSI）及最高基频（highest frequency,F0-High）等方面显著高于对照组,差异有统计学意义（P <0.05）;在基频微扰（Jitter）方面显著低于对照组,差异有统计学意义（P <0.05）。两组患者在基频（Fundamental frequency,F0）、最低音强（lowest intensity,I-Low）及振幅微扰（Shimmer）等方面差异无统计学意义（P >0.05）。结论　声带息肉围手术期嗓音训练有助于患者嗓音的恢复。     

Acoustic Analysis of Voice in Cochlear Implant Recipients with Post-Meningitic Hearing Loss

The objective of this study was to evaluate the critical time period between the onset of sensorineural hearing loss and cochlear implantation with respect to normal voice production in children with post-meningitic hearing loss. Acoustic measures of voice production were obtained from ten paediatric cochlear implant recipients with post-meningitic hearing loss. Acoustic measures were obtained utilising the Multi-Dimensional Voice Program and Computerized Speech Laboratory (Kay Elemetrics Corp.). Measures were based on sustained phonation of the vowel /a/. Acoustic parameters included fundamental frequency, short- and long-term frequency perturbation, and short- and long-term amplitude perturbation. Measures of fundamental frequency and short-term frequency and amplitude perturbation were comparable to values of children with normal hearing. Long-term control of frequency was within normal limits for subjects with a period of auditory deprivation of less than four months. Measures of long-term amplitude perturbation were normal for all patients except those with cochlear ossification. Early restoration of auditory feedback with cochlear implantation, the absence of cochlear ossification, residual aided hearing following meningitis, and auditory-verbal therapy were identified as factors in preserving the long-term control of frequency and amplitude in the setting of post-meningitic hearing loss.     

Self-organizing map for the classification of normal and disordered female voices.

The goal of this research was to train a self-organizing map (SOM) on various acoustic measures (amplitude perturbation quotient, degree of voice breaks, rahmonic amplitude, soft phonation index, standard deviation of the fundamental frequency, and peak amplitude variation) of the sustained vowel /a/ to enhance visualization of the multidimensional nonlinear regularities inherent in the input data space. The SOM was trained using 30 spasmodic dysphonia exemplars, 30 pretreatment functional dysphonia exemplars, 30 post-treatment functional dysphonia exemplars, and 30 normal voice exemplars. After training, the classification performance of the SOM was evaluated. The results indicated that the SOM had better classification performance than that of a stepwise discriminant analysis over the original data. Analysis of the weight values across the SOM, by means of stepwise discriminant analysis, revealed the relative importance of the acoustic measures in classification of the various groups. The SOM provided both an easy way to visualize multidimensional data, and enhanced statistical predictability at distinguishing between the various groups (over that conducted on the original data set). We regard the results of this study as a promising initial step into the use of SOMs with multiple acoustic measures to assess phonatory function.     

成人女性嗓音障碍的客观多参数分析

目的：探讨嗓音客观多参数分析与主观听感知评估的相关性，建立嗓音客观多参数评估模型，实现嗓音评估的客观化和数据化。方法：声音样本采自83例嗓音障碍患者和40例嗓音正常者，全部受试者均为女性。客观检测采用Dr．Speech Science for Windows嗓音评估软件，在长元音/α：/上测试下列参数：基频、基频微扰(jitter)、振幅微扰(shimmer)、基频标准差、基频震颤、振幅震颤、标准化噪声能量(NNE)、谐噪比(HNR)、信噪比和最大发声时间(MPT)。主观听感知评估参数采用日本言语音声学会声音嘶哑评估GRBAS系统中的总嘶哑度，4级评估标准。结果：应用逐步判别分析方法，建立了5个参数(MPT、jitter、NNE、HNR和shimmer)的嗓音客观评估模型。客观评估结果与主观评估结果的一致性达到79．8％。结论：嗓音的客观评估是多参数的；嗓音的客观多参数评估模型与主观听感知结果有较好的一致性。     

Cepstral Analysis of Voice in Patients With Thyroidectomy

ObjectivesThe vocal changes after a thyroidectomy are temporary and nonsevere, therefore, obtaining accurate analytical results on the pathological vocal characteristics following such a procedure is difficult. For a more objective acoustic analysis, this study used the cepstral analysis method to examine changes in the patients’ voices during the perioperative period regarding sustained vowel phonation.MethodsThe sustained phonation of the five vowels (i.e., /a/, /e/, /i/, /o/, and /u/) by 35 patients with thyroidectomy were recorded by using a Multi-Speech program. Of the 35 patients, 10 were men and 25 were women, with an average age of 51.5 years. Voice data were collected a total of 3 times (preoperatively, 5–7 days after the operation, and 6 weeks after the operation) and were edited according to each fragment (on-set, mid, and off-set) for cepstral analysis.ResultsThe cepstral analysis on the patients’ voices revealed no significant differences between the examination periods of all vowel phonations. However, analysis of the on-set fragment of the vowel /i/ revealed pathological characteristics in which the cepstral measurements of the voice were significantly lower after the operation than before the operation, with the cepstral measurements of the voice increasing further 6 weeks following surgery.ConclusionThe results of the acoustic analysis on the on-set fragment of the vowel /i/ will be important data for characterizing the vocal changes during the perioperative period. This study contributes to future research on the mechanisms underlying changes in the voice of patients with a history of thyroid or neck surgery.     

成人嗓音计算机检测及分析

为研究不同性别及年龄阶段我国正常成人嗓音的声学特征以及不同发音方式下声带振动的特性，应用计算机语音频谱分析技术在９０例２０－５０岁正常人的噪音进行了声学参数测量。