注射喉成形术后声域中声带接触的变化

文献信息

中文摘要

理由： 单侧声带麻痹（UVFP）导致声门闭合不全，其严重程度在发声范围内变化，然而治疗结果通常通过单一发声努力水平下的感知评分或声学指标来评估。本研究使用声音映射（一种在基频-声压级平面上逐周期计算声学和电声门图指标的方法）来表征注射喉成形术对UVFP患者整个声域的影响。
方法： 研究了两个互补队列：八名患者在注射透明质酸或羟基磷灰石钙之前和之后立即进行评估，以及五名患者注射自体脂肪并在一个月和三个月时进行随访。
结果： 差异图和发声类型聚类分析一致表明，声门内移的主要效果是逐周期不规则性的减少，提示改善的振动规律性，而非简单的接触幅度增加，可能是临床声音改善的主要机制。
结论： 这些发现为注射喉成形术的生理学提供了空间分辨的视角，这是传统评估无法获得的，并支持进一步开发声音映射作为UVFP管理中的客观监测工具。

英文摘要

RATIONALE: Unilateral vocal fold paralysis (UVFP) causes glottic insufficiency that varies in severity across the phonation range, yet treatment outcomes are typically evaluated through perceptual ratings or acoustic indices obtained at a single vocal effort level. This study used voice mapping, a method that computes acoustic and electroglottographic metrics cycle-by-cycle across the fundamental frequency-sound pressure level plane, to characterise the effects of injection laryngoplasty across the voice field in patients affected by UVFP.
METHODS: Two complementary cohorts were studied: eight patients assessed before and immediately after injection with hyaluronic acid or calcium hydroxyapatite, and five patients injected with autologous fat and followed at one and three months.
RESULTS: Difference maps and phonation-type cluster analyses consistently showed that the predominant effect of glottic medialisation was a reduction in cycle-by-cycle irregularity, suggesting that improved vibratory regularity, rather than a simple increase in contact magnitude, may be the primary mechanism underlying clinical vocal improvement.
CONCLUSIONS: These findings offer a spatially resolved perspective on the physiology of injection laryngoplasty that is not accessible through conventional assessments, and support further development of voice mapping as an objective monitoring tool in the management of UVFP.