Objective assessment of autophony during phonation in the diagnosis of patulous Eustachian tube patients
Objective assessment of autophony during phonation in the diagnosis of patulous Eustachian tube patients
复制标题
客观评估发声过程中的自发声在咽鼓管扩张患者诊断中的作用
DOI：
10.1016/j.anl.2020.12.001
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发表时间：
2021
影响因子：
1.7
通讯作者：
Toshimitsu Kobayashi
中科院分区：
文献类型：
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作者：
Ryoukichi Ikeda;Shinji Hamanishi;Toshiaki Kikuchi;Hidetoshi Oshima;Yoshinobu Kawamura;Yusuke Kusano;Tetsuaki Kawase;Yukio Katori;Hiroshi Wada;Toshimitsu Kobayashi
目标 最近修订了一个系统，能够客观评估发声期间语音传输到外耳道 (EAC) 的情况。我们的目的是通过将使用该方法获得的结果与诊断 PET 的常规客观测试获得的结果进行比较，评估该新系统在诊断扩张性咽鼓管 (PET) 患者中的有效性。方法对医疗记录进行前瞻性调查，以明确的 PET、可能的 PET 和感音神经性听力损失作为对照。测量系统由个人计算机、AD/DA 转换器（NI 6361，美国国家仪器公司）、用于记录语音的探头麦克风系统（ER-10C，音特美研究）和两个用于测量 EAC 中噪声的麦克风（ER-10B+，音特美研究）组成。用这三个麦克风录制了 5 秒的“Ni”音。同时计算EAC中语音最大声压与噪声声的比值（EAC/Voice），并将结果显示在个人计算机上以供诊断。结果纳入确诊PET的患者31例42耳，可能PET的患者38耳26例，感音神经性听力损失患者12例24耳作为对照。对照组、明确 PET 组和可能 PET 组的 EAC/Voice 分别为 8.63 ± 5.43、25.41 ± 32.63 和 25.87 ± 24.93。对照组与明确PET组（p<0.05）和可能PET组（p<0.05）有显着差异。 ROC 曲线分析证实 14.7 是 EAC/Voice 的最佳诊断临界值（曲线下面积=0.782，95% CI 0.671–0.894）。通过采用这一分界点，确定 PET 组和可能 PET 组中分别有 25 只（56.8%）和 22 只（61.1%）耳被确定为阳性结果。本方法判断的阳性结果与对照组(r=-0.63,p=0.769)、确定PET组(r=0.12,p=0.451)和可能PET组(r=0.12,p=0.451)的声管测量结果无显着相关性。声音和引起的噪声在 EAC 中传输（EAC/语音）。这种方法似乎很有前途，因为它能够检测出传统使用的测试方法（例如不发声的声管测量法）的病例，从而提高 PET 诊断的准确性。
ObjectiveA system enabling the objective assessment of the transmission of voice sounds to the external auditory canal (EAC) during phonation has recently been revised. Our aim was to evaluate the effectiveness of this new system in the diagnosis of patulous Eustachian tube (PET) patients by comparing the results obtained using this method with those obtained from conventional objective tests to diagnose PET.MethodsA prospective survey of medical records was included with definite PET, possible PET, and sensorineural hearing loss as control. The measurement system consists of a personal computer, an AD/DA converter (NI 6361, National Instruments), a probe microphone system for recording voice sound (ER-10C, Etymotic Research) and two microphones for measuring noise sound in the EAC (ER-10B+, Etymotic Research). Pronouncing the "Ni" sound for 5 s were recorded with these three microphones. The ratio of the maximum sound pressure of voice sound and noise sound in EAC (EAC/Voice) was simultaneously calculated, and results were displayed on a personal computer for diagnosing.ResultsThirty-one patients of 42 ears with definite PET, 26 patients of 38 ears with possible PET, and 12 patients of 24 ears with sensorineural hearing loss as control were included. The EAC/Voice were 8.63 ± 5.43, 25.41 ± 32.63, and 25.87 ± 24.93 in the control, definite PET, and possible PET group respectively. The control group was significantly different from the definite PET (p< 0.05) and possible PET group (p< 0.05). ROC curve analysis confirmed 14.7 as the best diagnostic cut-off value of EAC/Voice (area under the curve=0.782, 95% CI 0.671–0.894). By adopting this cut-off point, 25 (56.8%) and 22 (61.1%) ears were determined as positive findings in the definite PET and possible PET group, respectively. There was no significant correlation between the positive findings judged by the current method and that of sonotubometry in the control (r= -0.63,p= 0.769), definite PET (r= 0.12,p= 0.451), and possible PET group (r= 0.12,p= 0.451).ConclusionThe current system is more useful in the objective assessment of autophony during phonation by calculating the ratio of voice sound and elicited noise sound transmitted in the EAC (EAC/Voice). This method seems promising because it is able to detect cases eluding conventionally used test methods such as sonotubometry performed without phonation, thereby increasing the accuracy of PET diagnoses.