汉语声调在国内外人工耳蜗相关领域的研究现状

汉语普通话是我国正式官方语言,是语种中使用人数最多的语言.汉语普通话是一种声调语言(tone language),主要包括阴平(一声)、阳平(二声)、上声(三声)和去声(四声)四种声调[1],人们通过感知音调(pitch)的高低和变化来辨别不同的声调.同样声母和韵母组成的音节相同,但是搭配不同的声调,体现的词汇意义是不同的.因此,声调感知障碍可以直接导致言语感知功能异常.     

汉语声调对发育性语音障碍儿童塞音偏误的影响研究北大核心CSCD

目的探讨汉语声调对发育性语音障碍儿童塞音偏误的影响,为其临床康复治疗提供理论依据。方法选取4~6岁发育性语音障碍儿童28例(患儿组)及年龄相仿的正常儿童25例(正常组),以跟读复述的方式录取6个塞音(/b/、/d/、/g/、/p/、/t/、/k/)与单韵母/a/组成的包括汉语普通话四个声调的24个单音节词,通过praat语音分析软件提取各单音节词语的嗓音起始时间(voice onset time,VOT)值,采用混合方差分析的方法,分析两组在四种不同声调上同一塞音的VOT值差异。结果两组组别主效应显著,患儿组与正常组之间各音节VOT值存在统计学差异(P<0.001):正常组声调类型与声母类型交互作用不显著(P>0.05);患儿组声调类型与声母类型交互作用显著(P<0.001),声母/b/的VOT:/ba/1     

听神经病患者普通话单音节识别错误模式分析

目的 分析听神经病(auditory neuropathy,AN)患者单音节识别测试的错误模式,总结AN患者在言语识别障碍方面的特点,探讨单音节言语识别测试对于AN诊断的作用.方法 AN患者16例,共32耳;根据听力图曲线分为两个亚组:上升型听力组(15耳)和非上升型听力组(17耳).感音神经性聋患者22例(共32耳)作为对照组.使用自行编制的言语测试材料在较高的测试强度下进行单侧单音节识别测试,记录每个测试耳的单音节识别得分和错误模式.错误模式分为8种:仅声母错、仅韵母错、仅声调错、声母错+韵母错、声母错+声调错、韵母错+声调错、声韵调全错、无反应.结果 AN患者单音节总体识别得分低于感音神经性聋患者(P<0.001).上升型听力的AN患者其单音节识别率、声母、韵母、声调识别率与对照组感音神经性聋患者差异无统计学意义;非上升型听力的AN患者单音节识别率、声母、韵母、声调识别率均低于感音神经性聋患者(P值均<0.001).AN患者与感音神经性聋患者的单音节识别错误模式构成比差异具有统计学意义(P<0.001),前者涉及声调识别的错误所占比例较大.上升型听力AN患者单音节识别率和声母、韵母、声调识别率均高于非上升型听力AN患者(P值均<0.001).上升型听力AN患者与非上升型听力AN患者的单音节识别错误模式构成比差异具有统计学意义(P<0.001),前者涉及声调和韵母的识别错误所占比例较大.结论 普通话四声识别能力差是AN患者区别于感音神经性聋患者的一个重要特征.上升型听力AN患者与非上升型听力AN患者在单音节识别率、韵母和声调错误所占比例等方面存在特征性差异.心理物理测试对AN的诊断具有潜在的重要作用.     

语音学理论在普通话单音节小词表编录中的应用

目的 探讨以汉语语音学理论为依据编制普通话言语测听材料 (mandarin speech test materials, MSTMs) 单音节小词表,从全新角度建立更适用于临床应用的评估材料.方法 以语音学理论为基础,将声母、韵母进行归类缩减后拼合.按照拼合后的音节选择日常生活中常用字,编制完成单音节小词表.对编制材料进行数字化录音以及音频处理,形成CD测试材料,并对词表进行初步等价性评估.结果 编制出体现语音学特征的汉语普通话言语测听小词表24张,每表20个单音节字.结论 体现语音学特征的汉语普通话言语测听小词表可以明显缩短测试时间,但在临床推广前尚需等价性评估.     

一组普通话音位平衡单音节字表的文字编撰

目的编写一组适用于言语识别率测试的音位平衡的单音节测听词表。方法为兼顾测试的可靠性与临床实践中的效率,本课题将简短原则、音位平衡原则、常用字原则、覆盖原则、表间等价性等作为词表编写的主要原则。共设计了30张词表、每张词表包含25个单音节测试项。参照《声学手册》中的汉语音位一维概率分布,计算得到汉语拼音的22个声母(含零声母)、36个韵母、4个声调在30张词表、750个单音节测试项中的分布频次。基于音位平衡原则,通过计算机辅助编程和手动调整,从现代汉语常用字表的一级最常用汉字2500字和常用词表4000词中的单字词表中进行音节编选。结果形成了30张包含声母、韵母、声调在内的音位分配表。选取了489个音节,编撰了30张遵循音位平衡的单音节字表,每张表25字。结论该表文字稿是今后制作汉语音位平衡的单音节语音测试录音材料的基础。     

3岁听障与健听儿童开放式单音节测试结果比较分析

目的比较3岁听障儿童与同龄健听儿童开放式单音节测试结果,为提高康复教学效果提供依据。方法选取3岁听障儿童与同龄健听儿童各30例,采用言语听觉反应评估（evaluation of auditory response to speech ,EARS）中的开放式单音节分别对两组儿童进行测试,比较其结果。结果两组儿童各测试项得分高低排序均为声调得分＞韵母得分＞声母得分＞字得分,且两两之间的差异均有统计学意义（P＜0．01）;3岁听障儿童的声母、韵母和字得分均显著低于同龄健听儿童（ P＜0．001）。错误分析表明两组儿童中舌尖后音、边音的正确率均最低;健听儿童的双唇音、唇齿音、鼻音、塞音正确率最高,而听障儿童的舌根音正确率最高。听障儿童各发音部位及发音方法的声母、鼻韵母的正确率均显著低于健听儿童（P＜0．05）。结论3岁听障儿童在开放式单音节测试中的声母、韵母和字得分差于同龄健听儿童,且以舌尖后音、边音最为突出,这可能与听障儿童听力状况带来的输入性语言信息不足和听觉干预起始年龄有关。     

嗓音障碍RBH听感知评估系统的应用研究

目的 研究RBH听感知评估系统的可靠性及与客观嗓音参数的相关性,为其在我国的临床应用提供依据.方法 以10种常见的嗓音障碍疾病为研究对象,每种10例,并选取15例健康人,共115例作为受试者.参照德语版RBH主观听感知评估系统中粗糙声(roughness,R)、气息声(breathiness,B)和嘶哑声(hoarseness,H)的4个等级评分标准对受试者进行评分,检验5位评委间一致性和评委自身稳定性;分析受试者3个主观评估参数每相邻两个等级之间的客观参数的差异性;并将R、B、H与客观参数进行相关性分析.结果 每个评委前后两次评估的自身稳定性分析Kappa系数值为0.428～0.608,稳定性均比较好;5位评委间一致性分析的组内相关系数(intraclass correlation coefficient,ICC),前后两次分别为0.741 ～0.797和0.689 ～0.762,评委间一致性好.主观听感知评估参数R、B、H的4个等级中每相邻2个等级之间的基频微扰、振幅微扰、谐噪比、最长声时和发音障碍严重指数差异均具有统计学意义(P值均＜0.05).主观听感知评估参数R、B、H与客观评估参数基频微扰、振幅微扰、谐噪比、最长声时和发音障碍严重指数之间具有相关趋势(r值在0.360 ～0.551和-0.472 ～-0.620范围内,P值均＜0.01).结论 RBH主观听感知评估系统的可靠性好,等级分度合理,与客观参数评估的结果相关性好,临床应用前景广阔.     

人工耳蜗植入患者术后汉语声韵调识别能力临床分析

目的分析人工耳蜗（CI）植入患者术后普通话单音节声母、韵母、声调的识别能力差异,对比单双侧植入和植入时长对单音节识别的影响。方法选取单侧和双侧CI患者共63例,其中男35例,女28例,平均年龄（23.45±16.30）岁,CI植入时长（2.81±2.41）年。使用信度效度经已认证的单音节识别测试材料进行测试,记录每个患者声母、韵母、声调和总体的识别率得分情况。结果共获得70个测试结果：CI患者对声母、韵母和单音节总识别率均低于声调识别率且差异具有统计学意义（P=0.000 3;P=0.000 3;P=0.030 3）。对单音节总识别率超过50%的CI患者,声调识别率相比声母、韵母、单音节识别率显著性增高（P<0.005）。对于总识别率小于50%的患者,虽然声韵母识别率均低于声调识别率,但仅有韵母和声调之间差异具有统计学意义（P=0.018 9）。单双侧CI患者声调识别率差异无统计学意义(P>0.05),患者佩戴时长与单音节识别的相关性较弱。结论CI患者的声调识别效果较单音节以及声母和韵母更具有优势,声调识别会在使用CI一定时间后趋于较高水平。植入侧别对其影响较小。     

频域信息在感音神经性听力损失患者普通话声调感知中的作用

目的 探讨言语频域包络信息和精细结构信息对听力正常和感音神经性听力损失人群汉语普通话声调识别的作用.方法 采用线性预测编码技术对具有相同音节但不同声调的单音节字进行频域包络与精细结构的分离,将具有相同音节不同声调的单音节字的频域包络信息进行互换,合成128个新的具有来自于不同声调的频域包络和精细结构信息的“单音节字”.利用这些“单音节字”测试20名听力正常人与48例感音神经性听力损失患者(20例中度、20例中重度及8例重度)的声调感知能力.利用SPSS 15.0软件进行统计分析.结果 听力正常受试者99.7％的声调识别基于频域精细结构信息,中度至重度听力损失患者基于频域精细结构感知声调的识别率分别为97.7％,96.3％和83.0％.各组受试者均未依靠频域包络信息识别声调.三组听力损失患者依靠频域精细结构识别声调的能力均与听力正常受试者存在差异(x2=59.2,P＜0.001).感音神经性听力损失患者利用频域精细结构信息识别声调的能力与其听力损失程度呈负相关关系(r=-0.643,P＜0.001).结论 频域精细结构信息在普通话声调识别中起主要作用,精细结构存在时,频域包络信息对声调识别不起作用.感音神经性听力损失患者利用频域信息感知声调的模式与听力正常人群相似,伴随听力损失程度加重,其利用频域精细结构信息感知声调的能力缓慢降低.     

聋儿语音获得分析

目的分析聋儿语音获得情况及语音错误走向,据此提出教学建议。方法25个声韵母测试30例平均4岁7个月,平均听力损失重度以上聋儿的言语清晰度、语音获得情况并分析其错误情况,用三级人员评估法测试。结果被试聋儿掌握韵母发音的顺序为单韵母、复韵母、鼻韵母;最先掌握的声母为/b.p.d.t.m.l/等,其次为/h.f.s.x.n/等,较差的是/c.z.zh.ch.j.q.r/。结论以发音方法对声母进行分析,塞音正确率最高,塞擦音正确率低。从韵母的结构分类分析,单韵母成绩最好,其次是复韵母,然后是鼻韵母;声母的替代错误较多,韵母的添加错误最多。     

Human frequency-following response: representation of pitch contours in Chinese tones

Auditory nerve single-unit population studies have demonstrated that phase-locking plays a dominant role in the neural encoding of both the spectrum and voice pitch of speech sounds. Phase-locked neural activity underlying the scalp-recorded human frequency-following response (FFR) has also been shown to encode certain spectral features of steady-state and time-variant speech sounds as well as pitch of several complex sounds that produce time-invariant pitch percepts. By extension, it was hypothesized that the human FFR may preserve pitch-relevant information for speech sounds that elicit time-variant as well as steady-state pitch percepts. FFRs were elicited in response to the four lexical tones of Mandarin Chinese as well as to a complex auditory stimulus which was spectrally different but equivalent in fundamental frequency (f0) contour to one of the Chinese tones. Autocorrelation-based pitch extraction measures revealed that the FFR does indeed preserve pitch-relevant information for all stimuli. Phase-locked interpeak intervals closely followed f0. Spectrally different stimuli that were equivalent in F0 similarly showed robust interpeak intervals that followed f0. These FFR findings support the viability of early, population-based 'predominant interval' representations of pitch in the auditory brainstem that are based on temporal patterns of phase-locked neural activity.     

Botulinum toxin injections for essential voice tremor

Fifteen patients, 13 women and 2 men, with a mean age of 72.7 years (56 to 86 years) and a clinical diagnosis of essential voice tremor, were treated with botulinum injections to the thyroarytenoid muscles, and in some cases, to the cricothyroid or thyrohyoid muscles. Evaluations were based on subjective judgments by the patients, and on perceptual and acoustic analysis of voice recordings. Subjective evaluations indicated that the treatment had a beneficial effect in 67% of the patients. Perceptual evaluations showed a significant decrease in voice tremor during connected speech (p < .05). Acoustic analysis showed a nearly significant decrease in the fundamental frequency variations (p = .06) and a significant decrease in fundamental frequency during sustained vowel phonation (p < .01 ). The results of perceptual evaluation coincided most closely with the subjective judgments. It was concluded that the treatment was successful in 50% to 65% of the patients, depending on the method of evaluation.     

Vocalab: a new software for voice evaluation and therapy

When handling vocal pathologies, speech therapists need tools to visualise voice and speech, in order to correlate personal auditory analysis with accurate data. Vocalab2 is a spectral analysis tool designed for speech therapists, developed in partnership with INSA Toulouse, France. Vocalab is a simple and user-friendly tool with important features to be used during evaluation and therapy. The software is based on a set of phoniatric data and sophisticated real-time signal analysis (Fourier transform, fundamental detection). One of the key tools of Vocalab2 is the real-time spectrum for visualising, differentiating and comparing every cord approximation and speech movement. Animations are proposed for illustrating most phonemes, and videos related to folding cords in the case of pathologic and normal sound production are also proposed. An extensive test has been conducted during 18 month, with important feedback that has considerably improved the tool. The satisfaction ratio is around 8/10.     

Spectral characteristics of speech at the ear: implications for amplification in children.

This study examined the long- and short-term spectral characteristics of speech simultaneously recorded at the ear and at a reference microphone position (30 cm at 0 degrees azimuth). Twenty adults and 26 children (2-4 years of age) with normal hearing were asked to produce 9 short sentences in a quiet environment. Long-term average speech spectra (LTASS) were calculated for the concatenated sentences, and short-term spectra were calculated for selected phonemes within the sentences (/m/, /n/, /s/, [see text], /f/, /a/, /u/, and /i/). Relative to the reference microphone position, the LTASS at the ear showed higher amplitudes for frequencies below 1 kHz and lower amplitudes for frequencies above 2 kHz for both groups. At both microphone positions, the short-term spectra of the children's phonemes revealed reduced amplitudes for /s/ and [see text] and for vowel energy above 2 kHz relative to the adults' phonemes. The results of this study suggest that, for listeners with hearing loss (a) the talker's own voice through a hearing instrument would contain lower overall energy at frequencies above 2 kHz relative to speech originating in front of the talker, (b) a child's own speech would contain even lower energy above 2 kHz because of adult-child differences in overall amplitude, and (c) frequency regions important to normal speech development (e.g., high-frequency energy in the phonemes /s/ and [see text]) may not be amplified sufficiently by many hearing instruments.     

Development of a script of phonemically balanced monosyllable lists of Mandarin-Chinese

Objectives To develop a set of monosyllable audiometry test material that can be used in speech recognition testing in Mandarin Chinese. Materials and Methods In an effort to improve reliability and efficiency in clinical practice, a set of 30 test lists of 25 monosyllable test items each was designed with consideration of the following: length of the list, phonemical balance (PB), word utility frequency, coverage of common words, and equivalency among lists. The 30 lists contained 750 monosyllabic words and were constructed on the basis of Chinese phoneme distribution probability summarized in the Manual of Acoustic. The occurrence incidence of the 22 consonants, 36 vowels, and 4 tones of the Chinese Mandarin characters in the 30 test lists were calculated. To achieve PB, 489 monosyllables were selected from the 2500 most commonly used Chinese characters and the 4000 most commonly used Chinese phrases to compile the 30 monosyllable test lists using a computer algorithm with manual adjustment. Results Thirty phonemical balanced word lists of common Mandarin Chinese monosyllabic words were compiled. Each list consisted of 25 monosyllables. A total of 489 phonemes (consonants, vowels and tones) were included in the set. Conclusions This set of lists can potentially be used as the basic lists for future development of Mandarin PB monosyllable speech test materials.     

蜗轴骨化的人工耳蜗手术与术后神经电生理评价与主观检测

目的：探讨蜗轴骨化的人工耳蜗植入术和术后听觉神经电生理反应与听觉言语效果问题,为掌握人工耳蜗植入术的适应证提供参考。方法：在进行101例各种程度和类型的耳蜗骨化的人工耳蜗植入术中,涉及到耳蜗蜗轴骨化7例。耳蜗、蜗轴骨化的人工耳蜗植人术前均进行常规影像学检查。蜗轴骨化判断方法：按颞骨高分辨CT水平位和冠状位显示,正常耳蜗中央区的蜗轴结构呈中等密度,其CT值为400～630HU,骨化时蜗轴密度增高,CT值达900HU或以上,除外先天性等因素造成的蜗轴骨化或骨性闭锁等因素。进行术中和术后神经电生理与主观听觉言语检查。结果：7例耳蜗蜗轴骨化的人工耳蜗植入术中电极阻抗检查均正常。7例患者术后均进行EABR检查,1例术后无法引出可识别的EABR波形,其余6例均可以在中段或末端电极部位引出不典型的EABR波形。术后进行声场下的纯音检测：1例EABR无反应患者最大给声无反应;其余6例声场下纯音听力水平平均为75dB。术后听觉言语识别率：1例无听觉反应患者术后言语识别率为0,其余6例汉语普通话单韵母为100％、单声母为30％。结论：耳蜗完全骨化多数伴有蜗轴骨化,施行人工耳蜗植入的最佳方法是将多导电极环绕蜗轴旋转,其手术难度较大。蜗轴骨化的人工耳蜗植入术后听觉电生理反应呈现非典型表现,术后听觉言语效果很差,EABR无反应者存在无效的风险。     

The correlation between subjective and objective voice evaluation in organic and functional larynx disorders

The aim of this research is to develop and introduce into phoniatric diagnostic procedures the complex methodology of vocal function assessment, on the basis of comparison of subjective and objective voice estimation. The set of complex voice evaluation ought to include perceptual examination of the voice quality with quantitative GRBAS scale as a subjective method, vocal folds vibrations in videostroboscopy as a quasi-objective method and acoustic voice estimation in Multi Dimensional Voice Program (MDVP) as an objective method. The basic assumption of this report is to prove correlation existence for vocal folds vibration quality in videostroboscopy, parameters describing acoustic wave generating by vibration system in larynx (MDVP) and perceptual subjective voice assessment (GRBAS scale) in organic and functional voice disorders. Research was conducted on 100 subjects (65 with organic and 35 with functional voice disorder), aged 7-74 years randomly chosen from population of patients treated at the Department of Phoniatrics and Audiology, Karol Marcinkowski University School of Medical Sciences in Poznań in 1996-2001 and 60 subjects as a control group without any voice disorders according to phoniatric examination. The research methodology include perceptual voice evaluation based on Japanese (Hirano) GRBAS scale adapted to Polish language, in scale 0 to 3 as well as the vibrations of vocal folds in videostroboscopy with attempt at quantification (scale 1 to 3) of selected measure and for acoustic analysis of Multi Dimensional Voice Program (MDVP) for 17 estimated parameters. Due to results and statistic analysis the own, new scale of dysphonia severity was introduced.     

听力正常学龄前儿童语音发育规律研究

目的:初步探讨3～5岁听力正常儿童语音发育规律.方法:在建立汉语普通话3～5岁儿童日常生活口语词库的基础上,将词库中的单音节词分解成拼音音节及音素,计算字频、音素音节出现频率,并与成人组进行比较.结果:3～5岁儿童组口语词汇中出现全部汉语普通话所包括的音位,经独立样本t检验,与成人组言语中音位分布和频率分布差异无统计学意义.3岁组口语中出现音节323个,占成人音节总数的81.8%,4～5岁组出现369个,占93.4%.结论:3岁儿童言语中出现的音位分布规律和频率高低均与成人类似,提示此时儿童已基本完成言语发育中语音系统水平的发育.     

Auditory-perceptual scaling and quality of life in tracheoesophageal speakers

Objectives/Hypothesis The purposes of the study were to determine listeners' auditory‐perceptual ratings of tracheoesophageal speakers, to determine quality of life in tracheoesophageal speakers, and to determine the potential relationship between listeners' ratings of speech and tracheoesophageal speakers' self‐rated quality of life. Study Design Twenty‐eight laryngectomized individuals who used tracheoesophageal speech as their primary mode of communication were studied. Fifteen naïve listeners provided auditory‐perceptual ratings. Methods Twenty‐eight tracheoesophageal speakers (22 men and 6 women) completed a general information form, in addition to the University of Michigan Head and Neck Quality of Life (HNQOL) instrument; speakers also provided connected speech samples of a standard passage. Fifteen naïve listeners evaluated the tracheoesophageal speech samples for overall speech severity, naturalness, acceptability, and pleasantness using direct magnitude estimation procedures. Results Listeners were able to discriminate among tracheoesophageal speech samples relative to the auditory‐perceptual dimensions. Male tracheoesophageal speakers were judged as having significantly better, more acceptable, and more pleasant voices than women. Scores on the HNQOL instrument were determined to be higher among the group of tracheoesophageal speakers in the present study than those reported in previous studies. No significant differences were found among men and women for quality of life scores. Quality of life domains and auditory‐perceptual judgments of tracheoesophageal speech were moderately correlated. Conclusion Women who use tracheoesophageal speech may be differentially penalized for dimensions related to voice quality. Limitations in voice did not necessarily translate into worse overall quality of life, indicating that auditory‐perceptual evaluation and quality of life questionnaires are evaluating different aspects of function after laryngectomy.