声带息肉发生部位对嗓音参数的影响

Effects of the location of sessile vocal cord polyp on the acoustic parameters of voice

目的观察广基性声带息肉发生部位及其大小对嗓音声学参数的影响。方法 180名拟行手术治疗的女性声带息肉患者,术前1天分别录元音/a/和/i/,应用MDVP软件进行声学参数分析;术中于声带缘处以Olympus内镜测量器测量息肉前端距声带前联合的距离(即息肉的位置)。比较分析参数F0、Jitt、PPQ、sPPQ、Shim、APQ、sAPQ、NHR与声带息肉发生部位的相关性。结果息肉位于声带前端或后部时对声带振动的影响较大。患者发/a/音时,声带中后部息肉的Jitt值最大,而声带最前端和中后部息肉的PPQ、sPPQ指标增高;发/i/音时,不同位置声带息肉的Jitt、PPQ、sPPQ值差别不大。当息肉位于声带前中份时,发/a/和/i/音的3种指标小于位于其他部位者,但各组间数值差异无显著意义,且振幅指标的变化与息肉位置的关系不大,息肉位置与NHR变化无相关性。结论声带息肉的位置越接近中后部,其扰动指标越高;息肉大小和位置对发元音/a/和/i/时各种声学参数的影响略有不同。

Objective To investigate the effects of the location and size of sessile vocal cord polyp on the acoustic parameters of voice based on a clinical trial. Methods Included in this study were 180 female patients with sessile vocal cord polyp to be treated by laryngomicrosurgery, with their voice samples collected respectively during pronouncing the vowels Of/a/and/i/lasted for 3--4 seconds one day before the surgery for acoustic parameters analyzing with the software of MDVP. During the period of operation under general anesthesia, the distance between the anterior extremity of polyp and anterior commissure, i.e. the location of vocal polyp, was measured by Olympus measuring instrument. Then, a comparative analysis was made to these parameters as F0, Jitt, PPQ, sPPQ, Shim, APQ, sAPQ and NHR to explore their relationship with the location of vocal polyp. Results All the vocal polyps included in this study were unilateral and sessile. There was a larger impact on the vibration of vocal cord when polyp was localized in the anterior extremity or postmedian of vocal cord. The value of Jitt would be the highest during the period of pronoucing the vowel/a/, when vocal polyp located in the postmedian of vocal cord, while the values of PPQ and sPPQ would become bigger during the period of pronoucing the same vowel, when the polyp localized in the anterior extremity of vocal cordd. However, there were no significant differences in such parameters as Jitt, PPQ and sPPQ for various locations of polyps when pronoucing the vowel/i/. Once a polyp was localized in the antero-niddle part of vocal cord, the values of these 3 parameters would be less than them measured from a poly localized in any other parts when pronouncing the vowels of/a/and / i/, though there were no statistical significance in their differences seen, with no significant correlation of the location of vocal polyp with the change of amplitude and the value of NHR. Conclusions The more the location of polyp near to the postmedian of vocal cord, the higher the turbulence parameters of voice. However, there are somewhat different impact on the various acoustic parameters of voice when pronouncing the vowels of/a/and/i/with various size and location of vocal cord polyp.