气管食管言语中嗓音障碍的倒谱频谱指数（CSID）的可重复性及其与临床沟通指标的探索性关联
Reproducibility of the Cepstral Spectral Index of Dysphonia in Tracheoesophageal Speech and Exploratory Associations with Clinical Communication Measures.
文献信息
| PMID | 42930342 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yuki Kayo |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, 1076 Kiyuna, Ginowan, Okinawa 901-2720, Japan. |
| 期刊 | Audiology research |
| SCI 分区 | Q2 |
| IF | 2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景/目的： 倒谱频谱指数（CSID）最初是为喉源性嗓音障碍开发的。我们评估了其在气管食管（TE）言语中不同任务下的可重复性，以及与沟通指标和手术/解剖构型的关联。
方法： 前瞻性纳入54例习惯性TE言语者。录音包括持续元音/a:/和四个连续言语句子。重复分析使用同一录音并独立重新分段。采用组内相关系数（ICC）、测量标准误和平均绝对百分比差异（MAPD）评估可重复性。头颈癌患者功能状态量表（PSS-HN）言语分量表和视觉模拟量表（VAS）分别评估可理解度和感知清晰度。PSS-HN一致性采用带有序权重的Gwet AC2。Spearman相关检验经错误发现率校正。构型组间比较采用Kruskal-Wallis检验，并以Benjamini-Hochberg法校正，两两比较采用Bonferroni校正。
结果： 连续言语单次测量ICC在操作者内为0.987-0.998，评分者间为0.990-0.996；MAPD分别为1.02-1.99%和1.41-2.74%。持续元音ICC分别为0.749和0.874；MAPD分别为8.12%和5.26%。PSS-HN评分者内和评分者间AC2值分别为0.893和0.478。CSID与VAS的相关性较弱（绝对值ρ=0.239-0.468）。校正后，三个构型组在全部五项任务上均存在差异（所有q≤0.033）。在全部四项连续言语任务中，全喉切除术后将颈段食管假体置入者CSID低于置入重建组织者。持续元音的任意两两比较均无统计学意义。
结论： 连续言语CSID显示出高可重复性，而持续元音测量的变异性较大。构型组间差异无法分离假体置入部位的独立效应。与更广泛沟通指标的相关性仍属探索性。仍需针对TE言语、以嗓音质量评分为参照的进一步验证。
英文摘要
Background/Objectives: The Cepstral Spectral Index of Dysphonia (CSID) was developed for laryngeal dysphonia. We evaluated task-specific reproducibility in tracheoesophageal (TE) speech and associations with communication measures and surgical/anatomical configuration. Methods: Fifty-four habitual TE speakers were prospectively enrolled. Recordings comprised sustained /a:/ and four connected-speech sentences. Repeated analyses used the same recordings with independent resegmentation. Reproducibility was assessed using intraclass correlation coefficients (ICCs), standard error of measurement, and mean absolute percentage difference (MAPD). The Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) speech subscale and a visual analog scale (VAS) assessed comprehensibility and perceived intelligibility, respectively. PSS-HN agreement used Gwet's AC2 with ordinal weights. Spearman correlation tests underwent false-discovery-rate adjustment. Configuration-group comparisons used Kruskal-Wallis tests with Benjamini-Hochberg correction and Bonferroni-adjusted pairwise comparisons. Results: Connected-speech single-measure ICCs were 0.987-0.998 within operator and 0.990-0.996 between raters; MAPDs were 1.02-1.99% and 1.41-2.74%, respectively. Sustained-vowel ICCs were 0.749 and 0.874; MAPDs were 8.12% and 5.26%. PSS-HN within-rater and interrater AC2 values were 0.893 and 0.478, respectively. CSID-VAS correlations were modest (absolute ρ = 0.239-0.468). All five tasks differed across the three configuration groups after correction (all q ≤ 0.033). Across all four connected-speech tasks, CSID was lower with cervical-esophageal prosthesis placement after total laryngectomy than with placement into reconstructed tissue. No sustained-vowel pairwise comparison was significant. Conclusions: Connected-speech CSID showed high reproducibility, whereas sustained-vowel measurements showed greater variability. Configuration-group differences cannot isolate an independent effect of prosthesis insertion site. Associations with broader communication measures remain exploratory. Further TE-specific validation against voice-quality ratings remains necessary.