上颌快速扩弓对语音及气道的影响

Effects of rapid maxillary expansion on speech and airway

目的探究上颌快速扩弓治疗是否会对患者单元音和鼻韵母的发音及上气道结构产生影响,为临床医生正畸方案的设计提供一定的参考。方法选取2018年7月至2018年9月于中南大学湘雅二医院口腔医学中心正畸科就诊的上颌宽度发育不足患者20例,采用自身前后对照试验,在上颌快速扩弓治疗前后进行语音资料、影像学资料的收集,通过语音分析软件Praat和图像处理软件Dolphin进行数据测量。比较治疗前后的测量数据情况。结果治疗后,患者发音时单元音/a/F2(-46.1±93.8)Hz和/u/F1(-51.8±65.3)Hz的差异有统计学意义(P<0.05),单元音和鼻韵母共振峰变化率的平均值均低于10%;比较上颌快速扩弓治疗前后患者上气道腭咽段矢状径长度(0.88±0.73cm),差异有统计学意义(P<0.05)。结论上颌快速扩弓治疗可改变患者的上气道结构,影响部分单元音发音;上颌快速扩弓治疗前后患者单元音和鼻韵母的发音具有相对稳定性。

Objectives To investigate whether rapid maxillary arch expansion treatment affects the patient's unitary and nasal rhyme articulation and upper airway structure,and to provide some reference for clinicians in designing orthodontic protocols.Method A total of 20 patients with inadequate maxillary width hypoplasia who underwent rapid maxillary expansion treatment at the Second Xiangya Hospital of Central South University from July 2018 to September 2018 were selected.In a self-control study,the pronunciation and imaging data of the patients before and after maxillary expansion therapy were collected and measured by Praat and Dolphin analysis software and an image processing software,and compared measurement data before and after treatment.Results The formant frequencies of monophthongs/a/F2(-46.1±93.8)Hz and/u/F1(-51.8±65.3)Hz had statistically significant changes before and after maxillary rapid expansion(P<0.05).The average formant frequencies relatived deviations of the monophthongs and nasal consonant finals were lower than 10%.The difference was statistically significant in the sagittal length of the upper airway palatopharyngeal segment after maxillary arch expansion(0.88±0.73)cm(P<0.05).Conclusions Rapid maxillary expansion therapy affects the upper airway structure and patients'monophthongs phonation.The patients'pronunciations of monophthongs and nasal consonant finals keep relatively stable before and after rapid maxillary expansion.