Measurement reliability of phonation threshold pressure in pediatric subjects
Measurement reliability of phonation threshold pressure in pediatric subjects
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DOI：
10.1002/lary.27418
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发表时间：
2019-07-01
期刊：
影响因子：
2.6
通讯作者：
Jiang, Jack J.
中科院分区：
文献类型：
--
作者：
Hoffman, Matthew R.;Scholp, Austin J.;Jiang, Jack J.
目的/假设发声阈压（Phonationthresholdpressure，PTP）是发声所需的最小声门下压（P-s），对喉部生物力学的变化敏感，常随病理而升高。关于儿童PTP的报道很少;任务表现和测量可靠性的挑战是常规临床评估的障碍。研究设计初步研究评估PTP和P-s测量的可靠性，在儿童使用唇和机械中断。方法22名4 ~ 17岁（10.7 ± 3.9岁）的受试者参加了研究。每种方法进行了10次试验;任务顺序是随机的。对于唇中断，受试者在最软（起始PTP）和舒适振幅下产生/p α/五次。对于机械中断，受试者产生持续的/alpha/，同时球囊阀中断发声5次，每次250 ms;机械中断用吹口和面罩进行。PTP记录为P-s和发声停止时声门上压之间的差异（偏移PTP）。比较平均PTP和P-s以及受试者内变异系数。与年龄的相关性进行了评估。结果平均PTP（P <0.001）和P-s（P = 0.005）高于唇中断。不同方法间PTP（P = .554）和P-s（P = .305）的受试者内变异系数相似。仅机械面罩试验的变异系数与年龄相关（r =-0.628，P = .00175）。结论平均值的差异可能与任务和PTP滞后效应的差异有关。所有方法的可靠性都相当;对于机械中断，使用吸嘴可能优于面罩。PTP的测量是无创的，可靠的，并可能是一个有用的辅助儿童的声音评估。证据等级3b喉镜，129：1520-1526，2019
Objectives/Hypothesis Phonation threshold pressure (PTP), the minimum subglottal pressure (P-s) required for phonation, is sensitive to changes in laryngeal biomechanics and is often elevated with pathology. Little is reported on PTP in children; challenges with task performance and measurement reliability represent barriers to routine clinical assessment. Study Design Pilot study evaluating PTP and P-s measurement reliability in children using labial and mechanical interruption. Methods Twenty-two subjects aged 4 to 17 years (10.7 +/- 3.9 years) participated. Ten trials were performed for each method; task order was randomized. For labial interruption, subjects produced /p alpha/ five times at softest (onset PTP) and comfortable amplitude. For mechanical interruption, subjects produced a sustained /alpha/ while a balloon valve interrupted phonation five times for 250 ms each; mechanical interruption was performed with a mouthpiece and mask. PTP was recorded as the difference between P-s and supraglottal pressure at phonation cessation (offset PTP). Mean PTP and P-s and intrasubject coefficients of variation were compared. Correlations with age were evaluated. Results Mean PTP (P < .001) and P-s (P = .005) were higher for labial interruption. Intrasubject coefficients of variation for PTP (P = .554) and P-s (P = .305) were similar across methods. Coefficient of variation was related to age for mechanical-mask trials only (r = -0.628, P = .00175). Conclusions Differences in means are likely related to differences in task and PTP hysteresis effect. Reliability is comparable with all methods; using a mouthpiece may be preferable to a mask for mechanical interruption. Measurement of PTP is noninvasive, reliable, and may be a useful adjunct in pediatric voice assessment. Level of Evidence 3b Laryngoscope, 129:1520-1526, 2019