Detection of voice changes due to aspiration via acoustic voice analysis
Detection of voice changes due to aspiration via acoustic voice analysis
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DOI：
10.1016/j.anl.2017.10.007
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发表时间：
2018-08-01
影响因子：
1.7
通讯作者：
Koo, Bon Seok
中科院分区：
文献类型：
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作者：
Kang, Young Ae;Kim, Jaeock;Koo, Bon Seok
目的：吞咽时可发生误吸。本研究探讨了通过声学嗓音参数识别误吸风险(AR)的可行性。材料和方法：共有165名患者接受了视频透视吞咽检查(VFSS)。根据VFSS结果将患者分为AR组和非AR组。AR组包括59名患者(男性42名，女性17名)，他们的食材位于声带之上或之下。吞咽正常的非AR组包括106例患者(男49例，女57例)。吞咽障碍的主要原因是中风。在吞咽前后记录至少3个S的持续元音/a/。用PRAAT测量了8个声学语音参数，包括基频、F0的标准差、抖动、相对平均微扰(RAP)、微扰、幅度微扰商(APQ)、谐波噪声比(HNR)和噪声谐波比(NHR)。结果：仅RAP组(非AR组和AR组)与时间(吞咽前和吞咽后；p=0.030)之间存在显著交互作用。AR组吞咽后RAP降低，而非AR组RAP升高。吞咽后非AR组JITER和NHR增加，AR组JITER和NHR降低，但差异无统计学意义。结论：在穿透吸入术患者中，声带中糊状食物的积聚可能改变了声带的振动，改变了嗓音质量。几个声学语音参数，特别是抖动、RAP和NHR，都受到AR的影响。因此，声学嗓音分析可能有助于AR的诊断，作为标准吞咽检查的辅助工具，包括VFSS或纤维光学检查。(C)2017爱思唯尔B.V.保留所有权利。
Objective: Aspiration can occur during swallowing. The present study investigated the feasibility of identifying aspiration risk (AR) via acoustic voice parameters.Materials and methods: In total, 165 patients scheduled for a videofluoroscopic swallowing study (VFSS) were included. The patients were divided into two groups (AR and non-AR) based on their VFSS results. The AR group, which had ingested materials on or below the vocal folds, included 59 patients (42 males and 17 females). The non -AR group, which showed normal swallowing, included 106 patients (49 males and 57 females). The major cause of swallowing disorders was a stroke. A sustained vowel/a/for at least 3 s was recorded before and after swallowing. Eight acoustic voice parameters were measured using PRAAT, including fundamental frequency, standard deviation of F0, jitter, relative average perturbation (RAP), shimmer, amplitude perturbation quotient (APQ), harmonic-to-noise ratio (HNR), and noise-to-harmonic ratio (NHR). Changes in each acoustic voice parameter before and after the VFSS were compared between the two groups with a repeated-measures mixed analysis of variance.Results: Only RAP showed a statistically significant interaction between group (non -AR and AR) and time (pre- and post-swallowing; p = 0.030). RAP decreased after swallowing in the AR group; however, it increased in the non -AR group. Jitter and NHR increased in the non -AR group but decreased in the AR group after swallowing, but the difference was not statistically significant.Conclusions: Our results suggest that the accumulation of pasty food in the vocal folds may modify vocal fold vibration and change voice quality in patients with penetration/aspiration. Several acoustic voice parameters, especially jitter, RAP, and NHR, were affected by AR. Thus, acoustic voice analysis may be helpful in making a diagnosis of AR as a supplementary tool for standard swallowing study including VFSS or fiberoptic examination. (C) 2017 Elsevier B.V. All rights reserved.