A Case Report in Changes in Phonatory Physiology Following Voice Therapy: Application of High-Speed Imaging
A Case Report in Changes in Phonatory Physiology Following Voice Therapy: Application of High-Speed Imaging
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DOI：
10.1016/j.jvoice.2012.01.001
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发表时间：
2012-11-01
期刊：
影响因子：
2.2
通讯作者：
Donohue, Kevin D.
中科院分区：
文献类型：
--
作者：
Patel, Rita R.;Pickering, Jack;Donohue, Kevin D.
目标。临床评价嗓音治疗对接触性肉芽肿性沙哑患者声带振动和发声的影响。使用多种声带功能测量的单受试者前后前瞻性研究。本文对一位51岁男性单侧接触性肉芽肿患者进行了为期6周的声带功能练习（VFEs），通过对声带功能的多重评估来识别和测量治疗前后的变化。记录了多个结局指标。高速数字成像（HSDI）测量的声音开始时间（毫秒），打开商，速度商，最大振幅，峰关闭速度，峰平均打开速度，峰平均关闭速度，从运动数据导出。最大发声持续时间（秒）、噪声-谐波比、平均基频（赫兹）、最低基频（赫兹）和最高基频（赫兹）的声学测量；呼气容积（毫升）和平均呼气气流（升/秒）的气动测量；声门关闭和相位关闭的频闪测量；并采用共识听觉-感知评价法对语音质量（总分）进行了感性评价。频闪、声学、空气动力学和听觉测量对接触性肉芽肿患者治疗前后的声带功能的影响最小。HSDI测量提供了多种生理和运动学测量，显示了治疗前和治疗后声带功能的有效性，包括振动运动、闭合和冲击应力。该结果对使用高速成像来识别和测量接触性肉芽肿患者的发声生理变化具有重要意义。发声生理学的变化支持使用声音治疗技术，如VFEs，促进半封闭声道治疗接触性肉芽肿。
Objective. To clinically evaluate changes in vocal fold vibration and voice production caused by voice therapy in hoarseness resulting from contact granuloma.Design. Single-subject before-after prospective study using multiple measures of vocal function. A 6-week program of vocal function exercises (VFEs) was conducted using multiple assessments of vocal function to identify and measure the changes pre- and posttreatment, in a 51-year-old male with unilateral contact granuloma. Multiple outcome measures were recorded. High-speed digital imaging (HSDI) measures of voice onset time (milliseconds), open quotient, speed quotient, maximum amplitude, peak closing velocity, peak-to-average opening velocity, and peak-to-average closing velocity were derived from motion data. Acoustic measures of maximum phonation duration (seconds), noise-to-harmonic ratio, average fundamental frequency (hertz), the lowest fundamental frequency (hertz), and the highest fundamental frequency (hertz); aerodynamic measures of expiratory volume (milliliter) and mean expiratory airflow (liter/second); stroboscopic measures of glottal closure and phase closure; and perceptual assessment of voice quality (total score) using the Consensus Auditory-Perceptual Evaluation of Voice were obtained.Results. Stroboscopic, acoustic, aerodynamic, and audioperceptual measures were minimally informative related to pre- and posttreatment vocal function in a patient with contact granuloma. HSDI measures provided multiple physiologic and kinematic measures demonstrating pre- and posttreatment efficiency of vocal function, including vibratory motion, closure, and impact stress.Conclusion. The results have implications for the use of high-speed imaging to identify and measure change in phonatory physiology in patients with contact granuloma. Changes in phonatory physiology support the use of voice therapy techniques, such as VFEs that facilitate a semioccluded vocal tract for treatment of contact granuloma.