单侧环杓关节损伤嗓音声学检测

Acoustic analysis in patients with trauma to unilateral cricoary tenoid joint by computer technique

目的 :探讨计算机声学检测在诊断及治疗单侧环杓关节损伤患者中的应用价值。方法 :采用计算机嗓音声学测试系统 (Dr .SpeechScienceforWindows)对 5 0例正常成人及 30例单侧环杓关节损伤患者持续元音[a]信号进行检测 ,对其主要声学参数及声谱图特征进行比较分析 ,观察杓状软骨拨动治疗后嗓音声学性质变化。结果 :单侧环杓关节损伤嗓音各项声学参数值均较正常值明显增高 ,差别有显著意义 ;声谱图表现中高频区谐波及共振峰损害 ,声能减弱或消失 ,噪声成分增加。固定声带的位置直接影响嗓音声学性质 ,NNE更能客观反映声带的位置及声门闭合程度。杓状软骨拨动后 33%痊愈者显示声学参数及声谱图恢复正常 ;47%好转者表现声学参数值下降 ,声谱图谐波及共振峰逐渐恢复 ,噪声减少 ;2 0 %无效者术后声学特征无明显改变。结论 :计算机声学分析各项参数均可作为评价环杓关节损伤嗓音损害程度的定量指标 ,NNE可作为客观反映声带位置及声门闭合程度的定量参数。声谱图和声学参数结合 ,有助于对环杓关节损伤疗效及预后的客观评价。

Objective:To investigate the acoustic characteristics of unilateral cricoarytenoid joint trauma and evaluate the effect of acoustic analysis technique on the diagnosis and treatment of this disease.Method:The voice signals of sustained vowel were measured using a micro computer with Dr. Speech software in 50 healthy adults and 30 patients with unilateral cricoarytenoid joint trauma. The acoustic parameters (jitter, shimmer and NNE) and spectrographic characteristics (harmonic waves, formants and noise) were analyzed. The acoustic changes before and after the treatment of arytenoid motion were observed and compared.Result:All acoustic parameters were significantly increased in trauma of unilateral cricoarytenoid joint . The pathologic spectrograph showed decrease or loss of harmonic waves and formants , and increase of noise ,in middle and high frequencies. There was a relationship between NNE and the position of the vocal cord. After the treatment of arytenoid motion, 33% patients were cured and had normal acoustic parameters and spectrograph. 47% were improved with reduced parameters and improved spectrograph. The acoustics in 20% cases didn′t change at all after treatment. The acoustic parameters were significantly decreased after the treatment of arytenoid motion.Conclusion:The present study suggested that the acoustic parameters may estimating the degress of voice lesion as objective standards and NNE may judge the degree of glottic closure. Both acoustic parameters and spectrograph are of value in the diagnosis , treatment effect and prognosis observation to cricoarytenoid joint trauma.