Throat Clearing, Coughing, and Alternative Behaviors

总结 慢性清理行为在人群中普遍存在 患有声音障碍。清喉咙和咳嗽被认为是言语虐待 并且通常在声音治疗期间减少。虐待行为是 通常被较少滥用的清理动作所取代，包括：软喉咙清理， 无声咳嗽、吞咽困难以及吞咽液体丸时困难。虽然普遍存在 清除行为和减少使用这些行为的方法是众所周知的， 缺乏科学证据证明这些行为的“危害性”及其后果 与水分的关系。同样，还没有完成调查研究 向患者教授替代技术作为补偿策略。另外， 有害和替代性清除行为对清除粘液的有效性 并为患者提供缓解这种感觉的方法仍然未知。 这项研究的长期目标是确定特定药物的功效 声音障碍患者的声音卫生治疗的组成部分 提高治疗效率。建议开始实现两个具体目标 长期目标。第一个目标是比较生物力学、生理成分 发声、发声、软喉清、硬喉清、无声咳嗽、硬喉 正常语音参与者内部和之间的咳嗽。这一目标将集中在内部 这些行为期间参与者平均速度的差异。第二个目标是 比较清除前后粘液聚集和感觉消除的评级 六种清声行为中，软喉清、硬喉清、无声咳嗽、硬喉清 咳嗽、吞咽困难以及吞咽液体丸时困难。这两个目标的结果将是 与补水措施有关。这些目标将通过研究计划来实现 利用频闪检查、高速视频内窥镜和新颖的图像处理 技术。正常语音者和有声音障碍的人将参加 这项研究是为了进行比较。预计这项研究的结果 通过增加我们对行为的普遍了解，将与公共卫生相关 与声音病理有关。这项研究的结果应该提供更多 与患者护理方法直接相关的知识。叙事 四百万八万有嗓音障碍的人使用习惯 滥用清算行为，这被认为是最普遍的形式之一 声音滥用与引起声带损伤有关。通过利用数字高速 视频内窥镜、频闪镜、水合分析和图像分析技术，这 研究将提供声带动力学和运动学的客观数据 与这些行为相关的运动和振动，以及替代方案的数据 声音卫生教育和声音治疗中经常提倡的行为，以及 有害和改善性清除行为与水平的关系 保湿。预计这项研究的结果将与公众相关 通过增加我们对通常与声音相关的行为的了解来促进健康 病理学并与患者护理方法直接相关。

Summary Chronic clearing behaviors are prevalent throughout the population of persons with voice disorders. Throat clearing and coughing have been deemed vocally abusive and are typically targeted to be reduced during voice therapy. The abusive behaviors are commonly replaced with less abuse clearing maneuvers inclusive of: soft throat clear, silent cough, hard swallow, and hard swallow with a fluid bolus. Although the prevalence of clearing behaviors and methods to diminish the use of the behaviors are well-known, there is a lack of scientific evidence as to the 'harmfulness' of these behaviors and their relationship with hydration. Likewise, no research has been accomplished investigating the alternative techniques taught to patients as compensatory strategies. Additionally, the effectiveness of both harmful and alternative clearing behaviors to displace mucus and to provide the patient with relief from the sensation remains unknown. The long-term aim of this research is to determine the efficacy of specific components in vocal hygiene therapy for patients with voice disorders which will increase treatment efficiency. There are two specific aims proposed to begin to reach the long-term goal. The first aim is to compare biomechanical, physiological components of phonation, phonation onset, soft throat clear, hard throat clear, silent cough, and hard cough within and between normophonic participants. This aim will focus on within participant differences of average velocity during these behaviors. The second aim is to compare pre- and post-clearing ratings of mucus aggregation and sensation removal among six clearing behaviors, soft throat clear, hard throat clear, silent cough, hard cough, hard swallow, and hard swallow with a fluid bolus. The result of both aims will be related to hydration measures. The aims will be accomplished through a research plan utilizing stroboscopy, high-speed videoendoscopy, and novel image processing techniques. Normophonic speakers and persons with voice disorders will participate in this research to allow for comparisons. It is expected that the outcome of this research will be relevant to public health by increasing our knowledge of behaviors commonly associated with voice pathology. The results of this study should provide increased knowledge to relate directly to methods of patient care. Narrative Four million and eighty thousand persons with voice disorders use habitual abusive clearing behaviors, which are considered one of the most prevalent forms of vocal abuse and linked to causing vocal fold lesions. By utilizing digital high-speed videoendoscopy, stroboscopy, hydration analysis and image analysis techniques, this research will provide objective data on the dynamics and kinematics of vocal fold movement and vibration associated with these behaviors, as well as data on alternative behaviors often advocated for in vocal hygiene education and voice therapy, and the relationship of both deleterious and ameliorative clearing behaviors with level of hydration. It is expected that the outcome of this research will be relevant to public health by increasing our knowledge of behaviors commonly associated with voice pathology and relating directly to methods of patient care.