老年喉形态学改变与嗓音变化之间的关系  

Relationship between laryngeal morphology and voice changes in old people

作　　者：王丽萍[1] 高远[1] 杨静[1] 王瑾[1] 

机构地区：[1]中国医科大学附属第二医院耳鼻咽喉科,沈阳110004

出　　处：《中华耳鼻咽喉头颈外科杂志》2006年第9期657-660,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：留学回国人员科研启动基金(教外司留[1999]747号);辽宁省教育厅高等学校科研项目计划资助项目(05L457)

摘　　要：目的探讨老年喉形态学改变与嗓音变化之间的关系。方法对54例60岁以上健康老年人(男性29例,女性25例)的喉形态改变与嗓音声学特征进行了观察分析。健康青年对照组为21～22岁在校大学生46例,男女各23例。结果老年男性声带萎缩16例(55.2%),声门闭合不良18例(62.1%),声门下黏膜水肿16例(55.2%),室带超越(指发音时室带遮盖声带的部分或全部)12例(41.4%)。老年女性杓间区水肿15例(60.0%),声门闭合不良14例(56.0%),声带萎缩12例(48.0%),声带水肿8例(32.0%)。老年嗓音男性基频升高、女性基频下降,频率微扰、振幅微扰及噪谐比增大,嗓音的颤抖强度指数增加,特别是老年男性嗓音具有软发声特征。除老年女性频率微扰、振幅微扰及软发声指数升高无统计学意义外,其他参数与健康青年对照组比较,两者之间的差异均有统计学意义(P 值均小于0.05或0.01)。结论老年人在喉形态和嗓音声学特征上均出现了明显变化,除声带萎缩、声带水肿外,声门下黏膜水肿与杓间区水肿的发生率也很高。Objective To investigate the relationship between laryngeal morphologic changes and voice changes in old people. Methods Fifty four healthy people older than 60 years were studied. Laryngeal morphologic changes and vocal acoustics features were observed and analyzed. Forty six college students aged between 21 -22 years were included as the young control group, and 23 of them are males and 23 females. Results Sixteen cases with vocal fold atrophy （55.2%） , 18 cases with glottis incompetence （62. 1% ） , 16 cases with hypoglottic mucosal edema （55.2%） , 12 cases with surpassing ventricular fold （refers to the phenomenon that the ventricular fold covers part or all of the vocal cord during phonation ） （41.4%） were observed in the old male; 15 cases with edema of interarytenoid fold （60. 0% ） , 14 cases with glottis incompetence （56.0%）,12 cases with vocal fold atrophy （48.0%）,8 cases with vocal fold edema （32. 0% ） were observed in the old female. Fundamental frequency （F 0 ） ascended in the male while declined in the female; jitter, shimmer and noise to harmonic ratio enlarged, and vocal tremor intensity index increased too. Soft phonation was noticed especially in the voices of the old male. Compared with the control group, there was statistic significance （ each p value is less than 0. 05 or 0. 01 ） except for the increasing of jitter, shimmer and soft phonation index in the old female. Conclusions Significant changes were found in the old when the morphology of larynx and features of vocal acoustics were studied, hypoglottic edema and interarytenoid edema are common in the old.

关 键 词：老年人 喉 语音质量 喉镜检查 

分 类 号：R767[医药卫生—耳鼻咽喉科]