Extrinsic Laryngeal Muscle Tension in Primary Muscle Tension Dysphonia with Shear Wave Elastography.
Extrinsic Laryngeal Muscle Tension in Primary Muscle Tension Dysphonia with Shear Wave Elastography.
复制标题
用剪切波弹性成像研究原发性肌张力性发声障碍中的外在喉肌张力。
DOI：
10.1002/lary.30830
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Mau,Ted
中科院分区：
文献类型：
--
作者：
Shembel,AdriannaC;Morrison,RobertA;Fetzer,DavidT;Patterson-Lachowicz,Amber;McDowell,Sarah;ComstockSmeltzer,JuliannaC;Mau,Ted
目的：原发性肌张力性发声障碍（pMTD）患者的喉外肌（ELM）张力增高，但缺乏研究这一现象的工具。剪切波弹性成像（SWE）是解决这些缺点的潜在方法。本研究的目的是将SWE应用于ELMs，将SWE测量与标准临床指标进行比较，并确定pMTD和典型语音用户在发声load.MethodsSWE测量前颈部超声检查的ELMs，喉镜图像的声门上压迫严重程度，语音记录的倒谱峰值比频（CPP），和自我知觉评级的声音努力和不适，获得了在语音用户（N= 30）和没有（N= 35）pMTD，之前和之后的声音负荷challenge.ResultsELM紧张显着增加，从休息到发声条件在两组。然而，各组在基线、发声期间和发声后负荷时SWE的ELM刚度水平相似。在pMTD组中，发声努力和不适以及声门上压迫的水平显著更高，CPP显著更低。发声负荷有显着的影响，发声的努力和不适，但不是喉或acoustic patterns.ConclusionSWE可以用来量化ELM紧张与发声。尽管pMTD组报告了显著更高水平的发声努力和声道不适，并且平均而言，表现出显著更严重的声门上压迫和更低的CPP值，但使用SWE的ELM张力水平没有组间差异。证据等级2喉镜，133：3482-3491，2023
ObjectivesIt has been assumed that patients with primary muscle tension dysphonia (pMTD) have more extrinsic laryngeal muscle (ELM) tension, but tools to study this phenomenon lack. Shear wave elastography (SWE) is a potential method to address these shortcomings. The objectives of this study were to apply SWE to the ELMs, compare SWE measures to standard clinical metrics, and determine group differences in pMTD and typical voice users before and after vocal load.MethodsSWE measurements of the ELMs from ultrasound examinations of the anterior neck, supraglottic compression severities from laryngoscopic images, cepstral peak prominences (CPP) from voice recordings, and self‐perceptual ratings of vocal effort and discomfort were obtained in voice users with (N= 30) and without (N= 35) pMTD, before and after a vocal load challenge.ResultsELM tension significantly increased from rest‐to‐voiced conditions in both groups. However, the groups were similar in their ELM stiffness levels at SWE at baseline, during vocalization, and post‐vocal load. Levels of vocal effort and discomfort and supraglottic compression were significantly higher and CPP was significantly lower in the pMTD group. Vocal load had a significant effect on vocal effort and discomfort but not on laryngeal or acoustic patterns.ConclusionSWE can be used to quantify ELM tension with voicing. Although the pMTD group reported significantly higher levels of vocal effort and vocal tract discomfort and, on average, exhibited significantly more severe supraglottic compression and lower CPP values, there were no group differences in levels of ELM tension using SWE.Level of Evidence2Laryngoscope, 133:3482–3491, 2023