Praat软件及DSI对改良杓状软骨内收术治疗单侧声带麻痹的疗效评估

Objective Evaluation of Modified Arytenoid Adduction in the Treatment of Unilateral Vocal Cord Paralysis using Praat Software and Dysphonia Severity Index(DSI)

目的探讨Praat软件及嗓音障碍严重程度指数(dysphonin severity index,DSI)对改良杓状软骨内收术治疗单侧声带麻痹疗效评估的意义。方法 65例单侧声带麻痹患者均于患侧行改良杓状软骨内收术。全部病例于手术前及术后3月、12月分别行DSI分析及以Praat软件分析基频(fundamental frequency,F0)、声音强度(intensity)、噪谐比(NHR)、基频微扰[包括:局部基频微扰(jitter local)、局部绝对基频微扰(jitter local absolute)、基频微扰间期系数5(jitter ppq5)]、振幅微扰[包括:局部振幅微扰(shi mmer local)、局部振幅微扰dB(shi mmer localdB)、振幅微扰间期系数5(shi mmer apq5)]。结果术后3月、12月患者F0、NHR、jitter local、jitter local absolute、jitter ppq5、shi mmer local、shi mmer local dB、shi mmer apq5较术前明显下降,差异均有统计学意义(均为P<0.05)。术后3月、12月声音强度(intensity)分别与术前相比差异均无统计学意义(均为P>0.05)。术后3月、12月DSI值较术前均有显著提高(均为P<0.05)。术后12月上述所有指标与术后3月相比,差异均无统计学意义(均为P>0.05)。结论 Praat软件及DSI可客观、有效地评估改良杓状软骨内收术治疗单侧声带麻痹的疗效,该术式治疗单侧声带麻痹远期效果稳定。

Objective To assess the effectiveness of modified arytenoid adduction in the treatment of unilateral vocal cord paralysis using Praat software and Dysphonia Severity Index(DSI).Methods Six-five vocal cord paralysis patients treated with modified arytenoid adduction were retrospectively studied between Feb 2001 and Dec 2010.Parameters including fundamental frequency(F0),intensity,NHR,jitter local,jitter local absolute,jitter ppq5,shimmer local,shimmer local dB,shimmer apq5,were compared before,3 and 12 months after treatment using Praat software.DSI was also compared before,3 and 12 months after treatment.Results F0,jitter local,jitter local absolute,jitter ppq5,shimmer local,shimmer local dB,shimmer apq5,NHR decreased significantly 3 and 12 months after surgery compared with those of before surgery(P<0.05).There was no significant difference in intensity before,3 and 12 months after surgery.DSI increased significantly3 and 12 months after surgery(P<0.05).There was no significant difference in all the parameters between 3 and 12 months groups.Conclusion Modified arytenoid adduction,as a treatment for unilateral vocal cord paralysis,is of long-term stable results.Applcation Praat software and DSI for assessment of the treatment of voice disorder is effecive,convenient and reliable.