内收型喉肌张力障碍患者声带震颤的主观与定量评估
Subjective and Quantitative Assessment of Vocal Tremor in Patients With Adductor Laryngeal Dystonia.
文献信息
| PMID | 42832386 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Dexun Lin |
| 作者单位 | Department of Otolaryngology, Fujian Medical University Union Hospital, Fuzhou, China. |
| 期刊 | Journal of speech, language, and hearing research : JSLHR |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 本研究旨在通过频闪喉镜录像的视频特征追踪，对内收型喉肌张力障碍（ADLD）患者的声带震颤（VT）进行主观和定量分析，观察VT的发生率并描述震颤方向性和运动学参数，同时识别间歇性肌张力障碍性震颤（iDT）与规律性肌张力障碍性震颤（rDT）患者之间的差异。
方法： 一项回顾性分析纳入了55例临床诊断为ADLD的患者（ADLD组）和10例嗓音正常的对照者（正常组）。两名设盲的喉科医师评估频闪喉镜视频，并根据震颤规律性将伴有VT的ADLD患者分为iDT组和rDT组。采用视频追踪技术定量测量会厌、双侧室襞和双侧杓状软骨在水平方向和前后方向上的震颤幅度、周期和速度。
结果： 在61.82%（34/55）的ADLD患者中检测到VT，这些患者均为女性（34/49）。该发生率与对照组（0/10）及男性ADLD患者（0/6）相比具有统计学差异（p < .001）。主要震颤类型为水平型（52.94%，18/34）和混合型（41.18%，14/34）。水平方向震颤参数在ADLD组内或iDT组与rDT组之间均无显著差异（p > .05）。平均水平方向幅度为：会厌0.21个声带宽度；左/右室襞0.14/0.12个声带宽度；左/右杓状软骨0.16/0.13个声带宽度。在前后方向上，仅杓状软骨的幅度和速度显示组间差异（p < .05）。iDT组的会厌及双侧杓状软骨振荡幅度小于rDT组（p < .05）。平均前后方向幅度为：会厌0.33个声带宽度；左/右室襞0.12/0.16个声带宽度；左/右杓状软骨0.17/0.22个声带宽度。
结论： VT是女性ADLD患者的一个关键表型。视频追踪能够定量表征震颤运动学，并揭示rDT与iDT之间的客观幅度差异，为ADLD的客观诊断、亚型分型及治疗评估提供了方法学基础。
英文摘要
PURPOSE: The aims of this study were to subjectively and quantitatively analyze vocal tremor (VT) in patients with adductor laryngeal dystonia (ADLD) using video feature tracking of stroboscopic laryngoscopy recordings, to observe the VT incidence and characterize tremor directionality and kinematic parameters, and to identify differences between the patients with intermittent dystonia tremor (iDT) and regular dystonia tremor (rDT).
METHOD: A retrospective analysis included 55 clinically diagnosed ADLD patients (ADLD group) and 10 normal-voiced controls (normal group). Two blinded laryngologists assessed stroboscopic videos and classified ADLD patients with VT into iDT group and rDT group based on tremor regularity. Video tracking was used to quantitatively measure tremor amplitude, period, and velocity of the epiglottis, bilateral vestibular folds, and bilateral arytenoids in horizontal and anteroposterior directions.
RESULTS: VT was detected in 61.82% (34/55) of ADLD patients, all of whom were female (34/49). This incidence was statistically different than for controls (0/10) and for male patients with ADLD (0/6; p < .001). Predominant tremor types were horizontal (52.94%, 18/34) and mixed (41.18%, 14/34). Horizontal tremor parameters did not differ significantly within the ADLD group or between the iDT and rDT groups (p > .05). Mean horizontal amplitudes were epiglottis, 0.21 vocal fold widths; left/right vestibular folds, 0.14/0.12 vocal fold widths; and left/right arytenoids, 0.16/0.13 vocal fold widths. In the anteroposterior direction, only arytenoid amplitude and velocity showed intergroup differences (p < .05). The iDT group had smaller epiglottic and bilateral arytenoid oscillation amplitudes than the rDT group (p < .05). Mean anteroposterior amplitudes were epiglottis, 0.33 vocal fold widths; left/right vestibular folds, 0.12/0.16 vocal fold widths; and left/right arytenoids, 0.17/0.22 vocal fold widths.
CONCLUSIONS: VT is a key phenotype in female ADLD patients. Video tracking enables quantitative characterization of tremor kinematics and reveals objective amplitude differences between the rDT and iDT, providing a methodological basis for objective diagnosis, subtyping, and treatment evaluation of ADLD.
SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.34057596.