反流性咽喉病患者嗓音声学特征分析

目的观察反流性咽喉病(laryngopharyngeal reflux disease,LPRD)患者的嗓音声学特征。方法对耳鼻咽喉科门诊就诊的反流症状指数(reflux symptom index,RSI)量表评分总分≥13分的45例LPRD患者和36例正常成人进行硬管喉镜检查,并用德国XION DIVAS嗓音测试分析系统对两组受试者的持续元音信号进行检测分析,计算嗓音障碍指数(dysphonia severity index,DSI),比较两组结果,并分析LPRD患者RSI量表评分及声嘶症状评分与DSI值的相关性。结果 45例LPRD患者RSI评分均值为17.7±5.15分,喉镜检查表现为杓状软骨区红斑、充血、水肿、糜烂、溃疡,声门后区增生肥厚、肉芽肿和声带水肿、肥厚;LPRD组的基频微扰(jitter)及振幅微扰(shimmer)均值比正常对照组增高,最长发声时间(MPT)和DSI的均值LPRD组较正常对照组降低,差异均有统计学意义(P<0.01)。LPRD患者DSI值与RSI量表评分和声嘶症状评分呈负相关,相关系数分别为-0.344和-0.447(P<0.05)。结论 LPRD患者可出现嗓音异常,提示反流性咽喉病可能导致声带病理改变而造成嗓音损害。     

扁桃体切除术对成年男性嗓音功能的影响

目的 探讨扁桃体切除术对成年男性患者嗓音功能的影响.方法 对38例II度、III度扁桃体肥大或慢性扁桃体炎成年男性患者,在全麻下行等离子刀双侧扁桃体切除术,分别于术前、术后1、3个月行嗓音声学分析,比较手术前后发长元音/a/的嗓音基频(F0)、频率微扰(jitter)、振幅微扰(shimmer)、噪谐比(NHR)和第一...     

嗓音障碍指数对嗓音外科手术效果评估的价值

目的运用改良中文嗓音障碍指数量表,结合客观检查手段,评估嗓音障碍指数对嗓音疾病患者临床疗效分析的价值。方法 50例嗓音疾病患者手术前后分别进行自我评估、声学分析和喉镜检查。自我评估采用嗓音障碍指数(voice handicap index,VHI)量表中文版,包括功能(F)、生理(P)、情感(E)三方面评分,其总和记为T,其中,P+F=TvH;通过Dr.Speech嗓音分析软件对患者的嗓音样本进行声学分析,观察基频微扰(jitter)、振幅微扰(shimmer)、标准化噪声能量(normalized noise energy,NNE)三个指标。纤维喉镜检查主要观察声带闭合情况,记为C。结果 VHI量表中剔除了情感(E)方面后的嗓音自我评估分数,F、P、TvH之间的相关性良好,F、P、TvH与jit-ter、shimmer、NNE之间有良好的相关性,声带闭合程度(C)与VHI量表中的F、P、TvH以及jitter、shimmer、NNE之间有良好的相关性。结论改良的中文VHI量表,可有效地评估嗓音疾病严重程度及临床疗效,有较高的临床应用价值。     

年龄和性别因素对老年嗓音的影响

目的:探讨年龄及性别因素对正常嗓音造成的影响,为病理嗓音的诊断与疗效评估奠定基础。方法:随机选择18~40岁、60~90岁两年龄段的男、女性各33例,采用"喉功能检测仪"和"电声门图仪"进行嗓音声学测试,测试的嗓音参数主要包括:基频(F0)、基频微扰(Jitter)、振幅微扰(Shimmer)、噪声能量(NNE)、声门接触率(CQ),获得的数据采用SPSS13.0进行统计分析。结果:年龄与性别因素均对嗓音造成显著性影响,而且年龄与性别存在交互作用。其中对年龄或性别因素敏感的声学参数是F0、Jitter、NNE和CQ。结论:老年嗓音随着年龄增长存在特征性的改变,老年男女性的嗓音也存在不同的改变特征,老化嗓音通过发声训练可以得到改进。     

声带息肉的大小对嗓音参数的影响

目的 探讨声带息肉大小对嗓音参数的影响.方法 36名拟行手术治疗的女性单发性广基型声带息肉患者,术前1天在安静条件下分别录元音/a/和/i/,用MDVP软件分析相关声学参数.术中,于声带缘处以Olympus内镜测量器测量息肉前端至后端的距离(即息肉的长度).然后,分析息肉测量值与相关参数频率微扰Jitt、振幅微扰百分比Shim、噪谐比NHR的相关性.结果 发/i/音时,长5mm的息肉Jitt最大,声音愈显粗糙;发/a/音时,Shim值随息肉径度的增大而增加,振幅指标的变化受息肉大小的影响较大,声音越显嘶哑;NHR值随息肉的增大而变高.结论 声带息肉大小与声音嘶哑程度关系密切,不同大小的息肉对元音/a/和/i/的各种声学参数的影响略有不同.     

烟酒习惯对嗓音的影响初步研究

目的:通过烟酒组与对照组的嗓音参数对比研究,寻找具有鉴别力的参数,并通过参数的变化解释烟酒因素对嗓音的致病机制.方法:随机选择有烟酒嗜好的男性被试33名,对照组随机选择男性被试33名,身体健康,无烟酒嗜好、无耳鼻咽喉等疾病.采用"喉功能检测仪"和"电声门图仪"进行录音,要求被试发/ /音3s,对声音样本进行分析,分别获得F0、Jitter、NNE以及CQ的数据,采用多因变量组间对比研究.结果:烟酒组与对照组4项参数均差异有统计学意义(均P<0.01),其中烟酒组的F0、CQ值低于对照组;Jitter值、NNE值大于对照组.结论:烟酒嗜好对人类的嗓音具有损害作用;理论研究加上实验分析是选择敏感参数的有效方法;F0、Jitter、NNE以及CQ是衡量烟酒嗜好所致病理嗓音的有效表征参数,可用于监控此类病理嗓音的治疗效果.     

声带息肉发生部位对嗓音参数的影响

目的 探讨声带息肉大小对嗓音参数的影响.方法 36名拟行手术治疗的女性单发性广基型声带息肉患者,术前1天在安静条件下分别录元音/a/和/i/,用MDVP软件分析相关声学参数.术中,于声带缘处以Olympus内镜测量器测量息肉前端至后端的距离(即息肉的长度).然后,分析息肉测量值与相关参数频率微扰Jitt、振幅微扰百分比Shim、噪谐比NHR的相关性.结果 发/i/音时,长5mm的息肉Jitt最大,声音愈显粗糙;发/a/音时,Shim值随息肉径度的增大而增加,振幅指标的变化受息肉大小的影响较大,声音越显嘶哑;NHR值随息肉的增大而变高.结论 声带息肉大小与声音嘶哑程度关系密切,不同大小的息肉对元音/a/和/i/的各种声学参数的影响略有不同.     

远程嗓音训练对咽喉反流性疾病嗓音症状的疗效研究北大核心CSCD

目的:探究远程嗓音训练对咽喉反流性疾病（LPRD）患者嗓音症状的疗效。方法:前瞻性研究纳入2021年1月至2022年7月山西医科大学第一医院耳鼻咽喉头颈外科120例LPRD嗓音障碍患者,按照门诊就诊顺序通过计算机生成的随机数表将患者分为对照组（A组）、面对面嗓音训练组（B组）、远程嗓音训练组（C组）,对比分析3组间治疗第8周（阶段1）、治疗第12周（阶段2）及治疗结束后第6周（阶段3）的各疗效指标（主客观嗓音功能评价、反流症状评估）。采用SPSS 22.0进行统计学分析。结果:纳入研究的120例LPRD嗓音障碍患者（男63例,女57例,年龄18~65岁）。在阶段1时,3组间嗓音障碍指数（VHI）、反流症状指数（RSI）、反流体征评分（RFS）的差异具有统计学意义（ F=13.72, P<0.05;F=62.50, P<0.05;F=3.78, P<0.05）,B组及C组VHI、RSI显著小于A组,C组VHI、RSI显著小于B组;阶段2时,3组间最长发声时间（MPT）、嗓音障碍严重指数（DSI）、VHI、RSI、RFS的差异具有统计学意义（ F=8.49, P<0.05;F=3.24, P<0.05;F=8.55, P<0.05;F=19.92, P<0.05;F=12.19, P<0.05）,B组及C组MPT、DSI显著大于A组,B组及C组VHI、RSI、RFS显著小于A组,C组RFS显著小于B组;阶段3时,3组间基频微扰（Jitter）、MPT、DSI、VHI的差异具有统计学意义（ F=3.19, P<0.05;F=19.37, P<0.05;F=43.56, P<0.05;F=11.05, P<0.05）,3组间RSI、RFS的差异具有统计学意义（ F=25.58, P<0.05;F=11.82, P<0.05）,B组及C组MPT、DSI显著大于A组,B组及C组VHI、RSI显著小于A组,C组RFS显著小于A组及B组。 结论:远程嗓音训练可在特殊时期作为一种替代面对面嗓音训练的方式应用于LPRD。     

耳鼻咽喉门诊咽喉良性病变老年患者喉镜观察与嗓音声学分析

目的 探讨耳鼻咽喉门诊咽喉良性病变老年患者喉部形态特点及嗓音声学特征。方法 选取就诊的101例咽喉良性病变老年患者(≥60岁,男54例,女47例)为研究对象,行电子鼻咽喉镜检查、动态喉镜检查、咽喉反流症状指数评分(RSI评分)、反流体征评分(RFS评分)、嗓音声学分析检测,并对结果进行分析。结果 以声嘶为主诉就诊的老年患者男性明显高于女性(男性占53.7%,女性占29.8%),以咽痛与咽部异物感为主诉就诊的老年患者,男性比例略低于女性,分别为8.5%、13.0%,16.7%∶27.7%;合并胃病的老年患者,男性与女性比例为53.7%∶48.9%;有高血压等其他合并症的老年患者,男女基本持平,分48.1%、55.3%。老年患者动态喉镜结果中有声带闭合不全及黏膜波减弱表现的患者中男性比例略高于女性,分别为27.8%、10.6%、48.1%∶38.3%。有吸烟饮酒病史的老年患者RSI评分与无吸烟饮酒病史的老年患者之间无差异,然而有吸烟饮酒病史的老年患者RFS评分明显高于无吸烟饮酒病史的老年患者(P=0.001,P=0.001)。在对老年患者嗓音声学分析的研究中发现,性别、鼻部疾病及吸烟饮酒不...     

长时间经鼻气管插管对小儿喉部的影响及嗓音声学分析

本文对经鼻气管插管7天以上34例患儿,进行了喉部形态学的动态观察,并应用声谱仪对部分患儿进行了嗓音定量分析,从而客观地反映出插管对小儿喉部的影响及嗓音声学参数,试图确定一个相对合宜的置管时限及维持长时间人工气道较为安全有效的方法.     

The speaking fundamental frequency and the singing voice type

The objective of this study was to determine the speaking fundamental frequency (SFO) in professional opera singers and its dependence on their voice type, if any. A total of 75 persons were available for observation using a special computer clinical program. Male voices were categorized into three groups (viz, tenor, baritone, and bass), female ones into 2 groups (soprano and mezzo-soprano). It was shown that borderlines between SFO types varied within a wide range in all study groups. Significant differences in SFO were documented between tenors, baritones, and basses and between sopranos and mezzo-sopranos; the differences were insignificant between baritones and basses. It is concluded that the speaking fundamental frequency depends on the type of the singing voice; however this characteristic may serve only as an auxiliary tool but can not be used for the classification of singing voices.     

A comparative acoustic study of the speaking and singing voice during the adolescent's break of the voice

The observation of the vocal evolution of adolescent singers has shown it takes place in two stages, the singing voice changing after the speaking voice. The same pattern has been encountered and made more explicit with a study of 50 non-singer adolescents. It thus appears that the average pitch of the speaking voice deepening by one octave is not by itself the sign that the break of the voice has ended. This study also shows the individual nature of adolescent vocal evolution and its length (up to two years in one out of four cases).     

Acoustic markers to differentiate gender in prepubescent children's speaking and singing voice

Objectives

Investigation sought to determine whether there is any acoustic variable to objectively differentiate gender in children with normal voices.

Methods

A total of 30 children, 15 boys and 15 girls, with perceptually normal voices were examined. They were between 7 and 10 years old (mean: 8.1, SD: 0.7 years). Subjects were required to perform the following phonatory tasks: (1) to phonate sustained vowels [a:], [i:], [u:], (2) to read a phonetically balanced text, and (3) to sing a song. Acoustic analysis included long-term average spectrum (LTAS), fundamental frequency (F0), speaking fundamental frequency (SFF), equivalent continuous sound level (Leq), linear predictive code (LPC) to obtain formant frequencies, perturbation measures, harmonic to noise ratio (HNR), and Cepstral peak prominence (CPP). Auditory perceptual analysis was performed by four blinded judges to determine gender.

Results

No significant gender-related differences were found for most acoustic variables. Perceptual assessment showed good intra and inter rater reliability for gender. Cepstrum for [a:], alpha ratio in text, shimmer for [i:], F3 in [a:], and F3 in [i:], were the parameters that composed the multivariate logistic regression model to best differentiate male and female children's voices.

Conclusion

Since perceptual assessment reliably detected gender, it is likely that other acoustic markers (not evaluated in the present study) are able to make clearer gender differences. For example, gender-specific patterns of intonation may be a more accurate feature for differentiating gender in children's voices.     

Effect of the menstrual cycle on voice quality

The question addressed was whether most young women with no vocal training exhibit premenstrual hoarseness. Spectral (acoustical) analyses of the sustained productions of three vowels produced by 20 undergraduates at and at premenstruation were rated for degree of hoarseness. Statistical analysis of the data indicated that the typical subject was no more hoarse of premenstruation than at ovulation. To determine whether this finding represented a genuine characteristic of women's voices or a type II statistical error, a systematic replication was undertaken with another sample of 27 undergraduates. The finding replicated that of the original investigation, suggesting that premenstrual hoarseness is a rarely occurring condition among young women with no vocal training. The apparent differential effect of the menstrual cycle on trained as opposed to untrained voices deserves systematic investigation.     

Respiratory and laryngeal function during spontaneous speaking in teachers with voice disorders.

PURPOSE: To determine if respiratory and laryngeal function during spontaneous speaking were different for teachers with voice disorders compared with teachers without voice problems. METHOD: Eighteen teachers, 9 with and 9 without voice disorders, were included in this study. Respiratory function was measured with magnetometry, and laryngeal function was measured with electroglottography during 3 spontaneous speaking tasks: a simulated teaching task at a typical loudness level, a simulated teaching task at an increased loudness level, and a conversational speaking task. Electroglottography measures were also obtained for 3 structured speaking tasks: a paragraph reading task, a sustained vowel, and a maximum phonation time vowel. RESULTS: Teachers with voice disorders started and ended their breath groups at significantly smaller lung volumes than teachers without voice problems during teaching-related speaking tasks; however, there were no between-group differences in laryngeal measures. Task-related differences were found on several respiratory measures and on one laryngeal measure. CONCLUSIONS: These findings suggest that teachers with voice disorders used different speech breathing strategies than teachers without voice problems. Implications for clinical management of teachers with voice disorders are discussed.