悬雍垂腭咽成形术对嗓音的影响  

The influence of uvulopalatopharyngoplasty on speech

作　　者：关瑛[1] 王丽萍[2] 张明[1] 韩晓博[1] 杨骁[1] 

机构地区：[1]中国医科大学附属第四医院耳鼻咽喉头颈外科,辽宁沈阳110032 [2]中国医科大学附属第二医院耳鼻咽喉头颈外科,辽宁沈阳110004

出　　处：《东南大学学报（医学版）》2011年第2期340-343,共4页Journal of Southeast University(Medical Science Edition)

基　　金：辽宁省高等学校科研资助项目(2008749)

摘　　要：目的:探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)对嗓音的影响。方法:对42例诊断阻塞性睡眠呼吸暂停低通气综合征的患者在UPPP术前和术后1周,1、3个月时分别应用针对嗓音相关的主观调查问卷和电子计算机语音分析系统采集声学样本进行客观统计分析。结果:(1)患者调查问卷结果显示,42例患者中10例(23.8%)出现短时间的轻度腭咽闭合功能不全所致的鼻腔返流现象,15例(35.7%)患者发声有轻度鼻音增高,均于术后1周左右消失。1例歌唱爱好者诉唱高音区时较前感到吃力并高音有所降低。总体患者噪音障碍指数(VHI)量表和噪音相关生活质量(V-RQOL)量表评估值及鼻音问卷于术后1、3个月时无明显变化(均P>0.05)。(2)电子计算机语音分析术前与术后[a]、[i]、[u]、[ai]、[o]5个元音的声学参数结果显示,各元音基频(F0)经配对t检验显示差异无统计学意义(P>0.05);[ai]、[o]元音共振峰各峰值无变化(P>0.05),[a]元音、[u]元音第三、四共振峰有变化:术后1个月和3个月峰值均低于术前(P<0.01),[i]元音第三共振峰降低,第四共振峰增高,均差异有统计学意义(P<0.01)。结论:UPPP后患者对嗓音的主观心理听觉评估无明显变化;在客观声学检测各参数中仅[a]、[u]、[i]元音共振峰第三、四共振峰有变化。UPPP对嗓音有轻微影响。Objective： To study the influence of uvulopalatopharyngoplasty （UPPP） on speech. Methods： Sub- jective investigation and objective computerized phonography were carried on 42 patients with obstructive sleep ap- nea hypopnea syndrome （OSAHS） preoperatively, and 1 week, 1 month, and 3 months after operation, respective- ly. Results： The investigation showed that 10 of 42 cases （23.8%） presented temporary nasal backstreaming which figured mild velopharyngeal insufficiency and 15 cases （35.7%） presented mild hypernasality only within 1 week. The trying to sing high pitch by a singer was also relieved. VHI and V-RQOL investigations were no distinct differences in 1 and 3 months after operation （P 〉 0.05 ）. Acoustic parameter of [ a： ], [ i： ], [ u： ], [ ai： ~, [ o： ] vowels before and after operatione were analyzed by computerized phonography. Vowel fundamemtal frequency （FO） of each vowel had no differences （P 〉 0.05）. Each formant of [ ai： ] and [ o： ] had no change （P 〉 0.05）. One and 3 months after operation, F3 and F4 of, [ a： ] and [ u： ] fell （P 〈 0. O1 ）, F3 of [ i： ] fell （P 〈 O. 01 ）, F4 of[ i： ] grew （P 〈0.01 ）. Conclusion： There is no influence on subjective investigation after UPPP. Only F3 ang F4 of a： ], [ i： ], [ u： ] change on computerized phonography. UPPP influences speech slightly.

关 键 词：悬雍垂腭咽成形术 嗓音 语音分析 共振峰 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]