4—8岁儿童嗓音声学参数结果分析

目的 掌握正常学龄前及学龄期儿童的嗓音数据,为病理嗓音提供参考标准。方法 用Dr.speech嗓音分析软件采集4－6岁（学龄前）及7－8岁（学龄期）各120例儿童的嗓音资料,并对取得的数据进行统计分析。结果 测出学龄前期及学龄期儿童嗓音的基频微扰、振幅微扰、信噪比、谐噪比、噪声能量、平均基频及第一至第三共振峰,在性别及年龄段之间均无明显差异。结论 正常学龄前儿童和学龄儿童间所有参数均无差异。正常儿童与声带小结等喉疾患儿间各项参数有非常显著差异。     

汉族、纳西族、白族正常儿童嗓音声学和电声门图参数调查及其异同分析

目的 :探索汉族、纳西族、白族正常儿童嗓音声学和电声门图参数正常值及三者间差异。方法 :对 3个民族中 95 1例 4～ 8岁正常儿童用电子计算机及 Dr.speech系统软件进行嗓音声学 6项参数及电声门图 6项参数检测。并对同年龄组的声带小结和局部增厚患儿 30例进行检测。结果 :测出 3个民族的儿童嗓音声学和电声门图主要参数 ( 1基频微扰 2振幅微扰 3平均基频 4基频方差 5噪声能量 ) ,并列表对比分析。结论 :1汉族学龄前儿童和学龄儿童间全部参数无明显差异。但纳西族和白族学龄前儿童和学龄儿童间平均基频、基频方差均有明显差异。汉族与纳西族、白族间学龄儿童的平均基频、基频方差有非常显著性差异 ;2正常汉族儿童与声带小结等疾患儿童间各项参数有非常显著性差异     

喉癌与声带息肉患者嗓音的计算机定量评估

目的比较喉癌及声带息肉患者主要嗓音参数在不同检测方法中的变化,探讨喉癌与声带息肉对发声功能的影响。方法采用Dr．SpeechScienceforWindows（4．0）软件对正常成人、喉癌患者、声带息肉患者作嗓音声学分析和电声门图检测,并比较其主要参数的变化,分析各自嗓音质量评估的特点。结果①在喉癌和声带息肉患者中,两种嗓音检测方法的嗓音参数,基频微扰、振幅微扰、声门噪声能量均是有价值的,两者的基频微扰、振幅微扰、声门噪声能量可以互相替代,两种方法各参数间比较无统计学差异;②正常成人、喉癌患者、声带息肉患者平均基频之间无统计学意义,基频微扰、振幅微扰、声门噪声能量数值由低到高排列依次为正常成人组、声带息肉组、喉癌组,两两比较均有显著性差异（P〈O.05）;③嗓音质量由好到差排列为正常成人组、声带息肉组、喉癌组。结论计算机声学分析的各项参数可作为嗓音定量评价的客观指标,判断嗓音损害程度。     

声带小结及声带局部肥厚患儿嗓音声学及电声门图分析

目的 研究声带小结、声带局部肥厚患儿及正常儿童嗓音声学及电声门图参数之间的差异,为临床诊治提供依据.方法对342例正常儿童及76例声带局部肥厚患儿、52例声带小结患儿进行嗓音声学测试及电声门图分析,对三组参数进行方差分析并作两两比较.结果声带小结与声带局部肥厚患儿的嗓音声学分析的标准化噪声能量（NNE）与基频方差（SDFo）无显著差异,频率微扰（jitter）、振幅微扰（shimmer）在两组间差异有显著统计学意义;声带小结与声带局部肥厚患儿的电声门图频率微扰（jitter）、振幅微扰（shimmer）差异无统计学意义,NNE和SDFo在两组间差异有统计学意义.结论 jitter、shimmer、NNE、SDFo四项参数在区分正常嗓音和病理性嗓音时非常重要而且非常敏感;在病理性嗓音中以上四项参数各有异同;嗓音声学参数较电声门图参数更有意义.     

声带小结患者显微手术前后嗓音声学分析

目的探讨声带小结患者支撑喉镜下显微手术前后嗓音声学分析指标的变化。方法采用Xion声学分析软件对45例女性声带小结患者术前1天及术后第1周、第2周、第3周进行嗓音声学分析,并与45例正常对照组对比。结果声带小结患者术前基频微扰(jitter)、振幅微扰(shimmer)均高于正常对照组,嗓音障碍指数(DSI)低于正常对照组,差异均有统计学意义(P<0.01);术后1周患者的振幅微扰及基频微扰与术前1天相比均有一定程度降低,振幅微扰与术前相比差异有统计学意义(P<0.05),但基频微扰及DSI与术前相比差异无统计学意义(P>0.05);术后2周与术前1天比较,各声学参数值差异均有统计学意义(P<0.05),且与正常对照组相比无统计学意义(P>0.05);术后3周与术后第2周相比,三项声学指标差异无统计学意义(P>0.05)。结论声带小结患者术后各阶段嗓音恢复程度不同,术后二周嗓音声学分析结果趋于正常,基频微扰、振幅微扰及DSI可以作为声带小结手术疗效评价的敏感指标。     

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.     

病理嗓音的定量分析

目的通过病理嗓音与正常嗓音定量比较分析,探讨各种病理嗓音的特征.方法采用电脑多媒体技术,使用Dr.Speech软件,采样分析105例声带息肉、小结、慢性喉炎、喉癌、声带麻痹男女患者的嗓音资料.结果病理嗓音与正常人比较基频微扰、振幅微扰、谐噪比、信噪比、声门噪声等主要参数及基频方差差异有显著性,其余指标各有不同.结论嗓音分析是客观评估,其中NNE值对喉部疾患音质评估有较高价值.     

嗓音主客观分析在嗓音疾病诊断中的应用

目的探讨嗓音主客观分析在嗓音疾病诊断中的应用。方法利用计算机嗓音声学分析系统及电声门图仪同步检测50例正常受试者、139例嗓音疾病患者(包括声带息肉73例、声带小结14例、慢性声带炎31例、声带囊肿10例、声带任克水肿11例)的嗓音声学分析与电声门图的参数值,并采用声音嘶哑评估标准GRBAS系统中的总嘶哑度G对所有受试者进行主观听感知评估。结果嗓音疾病组基频微扰(jitter)、振幅微扰(shim-mer)、标准化噪声能量(NNE)均较正常对照组增大,谐噪比(HNR)及信噪比(SNR)均较正常对照组减小,差异均有统计学意义(P<0.01);随主观听感知评估嗓音总嘶哑度加重,基频微扰、振幅微扰及NNE值逐渐增大,HNR和SNR值逐渐减少。结论嗓音客观分析参数与主观听感知评估具有一致性,客观评估能反映主观听觉印象。     

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.     

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...     

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance Angiogenesis is essential for tumour growth and invasion. Vascular endothelial growth factor (VEGF) is a prime mediator of tumour angiogenesis. VEGF‐C is a closely related protein that effects lymphatic endothelial cells and may be important in the process of lymphatic metastasis. The purpose of this study was to evaluate the expression of these cytokines in patients with T1 and T2a glottic, squamous cell carcinoma, in comparison with normal epithelial control tissue, to ascertain any association with radioresistance. Twenty‐two tumours treated by radiotherapy (13 radiosensitive, nine radioresistant) and seven normal control tissues were studied. The minimum follow‐up was 2 years after radiotherapy. Expression of VEGF and VEGF‐C was evaluated by immunohistochemistry of formalin‐fixed, paraffin‐embedded biopsy specimens. Analysis was carried out using a quantitative computer image analyser. Both VEGF and VEGF‐C were detectable in tumour and normal control specimens. There was increased expression in tumour specimens of both VEGF (P = 0.03) and VEGF‐C (P < 0.001). In addition, the expression of VEGF‐C was associated with tumours of higher histological grade (P = 0.021). There was, however, no difference in VEGF and VEGF‐C expression between radioresistant and radiosensitive tumours. The expression of VEGF and VEGF‐C is increased in early laryngeal squamous cell carcinoma (SCC). However, measuring the expression of these proteins cannot predict radioresistance in this tumour group.     

Treatment of Maxillary Sinus Carcinoma: Clinical Results Using the Kitasato Modality

The conventional therapeutic regimen for maxillary sinus carcinoma consists of dissection of the maxilla, full-dose irradiation and extensive chemotherapy. However, the results obtained with this treatment are often poor. Even when patients recover, their quality of life is significantly reduced as a result of deformity of facial structures and swallowing and articulation dysfunctions. A retrospective analysis of 68 patients with maxillary sinus carcinoma treated with the Kitasato modality between 1975 and 1999 was conducted. All patients underwent pergingival maxillary sinus surgery combined with pre- and postoperative irradiation therapy with standardized total doses of 16 Gy; the postoperative irradiation was given in combination with regional intra-arterial infusion chemotherapy administered via the superficial temporal artery. All visible tumor lesions were removed where possible in order to preserve or facilitate cellular immunity after surgery. The cumulative 5-year survival rates were 85.7% for Stage II patients, 88.1% for Stage III, 76.6% for Stage IVA and 75.0% for Stage IVB.     

Tongue Base Reduction with Temperature-controlled Radiofrequency Volumetric Tissue Reduction for Treatment of Obstructive Sleep Apnea Syndrome

In recent years a considerable effort has been made to establish the use of different surgical techniques for the treatment of obstructive sleep apnea syndrome (OSAS). Nevertheless, treatment of hypopharyngeal obstruction due to tongue base hypertrophy remains in many ways an unsolved problem. The aim of this study was to evaluate the safety and efficacy of tongue base reduction with temperature-controlled radiofrequency volumetric tissue reduction in the treatment of OSAS. Twenty patients with OSAS and tongue base hypertrophy were treated with radiofrequency tissue ablation. An intensified treatment protocol was used, delivering 2,800 J per treatment session under local anesthesia. Two nights of polysomnography testing were performed before and after treatment. Daytime sleepiness, snoring and postoperative morbidity were assessed using questionnaires. Mean respiratory disturbance index (RDI) was reduced from 32.1 to 24.9/h after a mean of 3.4 treatment sessions. Six patients (33%) were cured after the procedure (reduction in RDI of &#83 50% and a postoperative RDI of <15/h) and ten (55%) showed an improvement of >20% in their RDI. Daytime sleepiness and snoring improved significantly. Peri- and postoperative morbidity was low; one severe complication occurred (tongue base abscess). We were able to achieve similar cure and responder rates to those reported in a recently published pilot study but with a reduced number of treatment sessions. We believe that this technique may improve patient acceptance and have beneficial cost implications.     

Cervical Reflex Induced by Click Stimuli in Cats

We studied click-evoked potentials in the anterior horn of the spinal cord in 17 cats. A concentric needle electrode was inserted into the anterior horn of the spinal cord at levels C3-C6. Potentials evoked with 105 dB SPL clicks were recorded with a peak latency of 4.89-5.10 ms only at the C3 level. These responses were observed 45-60 dB SPL above the auditory brainstem response (ABR) threshold, and no potentials were evoked by stimulation of the contralateral ear. Average was performed 100 times with changes in stimulation frequency of 1-20 Hz. The amplitude of the potentials decreased with increasing stimulus frequency, but there were no changes in ABRs. The responses disappeared after destruction of the medial vestibulospinal tract at the obex level, but ABRs were still recorded. The spinal nucleus of the accessory nerves was located in the anterior horn of the spinal cord at levels C1-C6, and the sternocleidomastoid muscle motoneurons were found at levels C1-C3. The click-evoked potentials recorded in this study reflect responses of the spinal nucleus of accessory nerves through the vestibulospinal tract to click stimulation. The responses have the same characteristics as vestibular-evoked myogenic potentials that can be recorded using surface electrodes over the sternocleidomastoid muscles of humans.     

Lack of significant estrogen and progesterone receptor expression in nasal telangiectasias in hereditary hemorrhagic telangiectasia: an immunohistochemical analysis

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring and apnea during sleep leading to decreased oxygen saturation and disturbed sleep, excessive daytime sleepiness and neuropsychological disturbances. This study investigates cognitive neuropsychological abilities in a group of 53 OSAS patients before and after treatment with uvulopalatopharyngoplasty. General intellectual ability, verbal learning and memory as well as executive functioning were measured at baseline and 6 months postoperatively. After surgery there were significant improvements in verbal learning and memory (mean change - 39, SD 57.3, p <0.001), recall (mean change - 24.3, SD 39.3, p <0.001) and executive functioning (as assessed by percentage of errors on the Wisconsin Card Sorting Test; mean change-9.1, SD 15.7, p <0.001). These improvements were in accordance with improvements in the degree of sleep apnea, the oxygen desaturation index (mean change -9.7, SD 15.9, p <0.001) and arterial minimum oxygen saturation (mean change 4.5%, SD 10.2%, p <0.01). Surgical treatment seems to improve verbal learning, memory and recall and executive functions in parallel with better oxygenation in OSAS.     

Measurement of chemosensory function

Although hundreds of thousands of patients seek medical help annually for disorders of taste and smell, relatively few medical practitioners quantitatively test their patients' chemosensory function, taking their complaints at face value. This is clearly not the approach paid to patients complaining of visual, hearing, or balance problems. Accurate chemosensory testing is essential to establish the nature, degree, and veracity of a patient's complaint, as well as to aid in counseling and in monitoring the effectiveness of treatment strategies and decisions. In many cases, patients perseverate on chemosensory loss that objective assessment demonstrates has resolved. In other cases, patients are malingering. Olfactory testing is critical for not only establishing the validity and degree of the chemosensory dysfunction, but for helping patients place their dysfunction into perspective relative to the function of their peer group. It is well established, for example, that olfactory dysfunction is the rule, rather than the exception, in members of the older population. Moreover, it is now apparent that such dysfunction can be an early sign of neurodegenerative diseases such as Alzheimer's and Parkinson's. Importantly, older anosmics are three times more likely to die over the course of an ensuring five-year period than their normosmic peers, a situation that may be averted in some cases by appropriate nutritional and safety counseling. This review provides the clinician, as well as the academic and industrial researcher, with an overview of the available means for accurately assessing smell and taste function, including up-to-date information and normative data for advances in this field.