悬雍垂腭咽成形术对OSAHS患者语音的影响  

The Effect of Uvulopalatopharyngoplasty on Voice in Patients with OSAHS

作　　者：丹静静[1] 陶树东[1] 黄永望[2] 

机构地区：[1]天津市第三中心医院耳鼻咽喉头颈外科、天津市人工细胞重点实验室,天津300170 [2]天津医科大学第二医院耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2015年第3期269-272,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨悬雍垂腭咽成形术(UPPP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发声功能和口鼻共鸣功能的影响。方法对30例确诊为OSAHS的成年男性患者行UPPP手术,分别在术前、术后1周及术后3月时通过多维嗓音分析软件、线性预测谱、鼻流计检测等方法,客观评估其发声功能和口鼻共鸣功能。结果术前、术后1周及术后3月患者的嗓音基频(F0)、频率微扰(jitter)、振幅微扰(shimmer)、谐噪比(NHR)差异无统计学意义(P>0.05);术后1周时元音/a/、/i/、/u/的F1、F2与术前差异无统计学意义(P>0.05);术后3月时元音/i/的F1、F2及元音/u/的F1与术前差异仍无统计学意义(P>0.05),但元音/a/的F1、F2及元音/u/的F2较术前升高,差异有统计学意义(P<0.05);术后1周时非鼻音句、口鼻音句、鼻音句的鼻音率与术前差异无统计学意义(P>0.05);术后3月时非鼻音句、口鼻音句的鼻音率较术前差异仍无统计学意义(P>0.05),但鼻音句的鼻音率较术前略有升高,差异有统计学意义(P<0.05)。结论 UPPP手术对OSAHS患者的发声功能无明显影响,但对口鼻共鸣功能有轻微影响;对职业用嗓者行UPPP手术需慎重。Objective To study the impact of changes in the pharynx on the vocal functions and resonance functions to evaluate the effects of UPPP on voice and in order to provide a reference for the selection of UPPP sur‐gery population .Methods The 30 male adult patients who underwent UPPP surgery were recorded pre-surgery ,1-week post-surgery and 3-month post-surgery speech .Then the multi-dimensional voice program （MDVP） , linear prediction coding （LPC） ,the Nasometer Ⅱ（model 6450） were used to evaluate the vocal functions ,the oral resonance functions and the nasal resonance function .Results F0 ,jitter ,shimmer ,and NHR were unchanged from the pre-surgery to the post-surgery condition .One week after the surgery ,F1 ,F2 of /a/,/i/and /u/were un‐changed （P〉0 .05） .Three months after surgery ,F1 ,F2 of the vowel /a/and F1 of the vowel /u/were remained essentially unchanged （P〉0 .05）;while the frequency of F1 ,F2 of the vowel /a/and of F2 of the vowel /u/were significantly higher compared to pre-surgery values （P〈0 .05） .One week after the surgery ,the nasalance scores of the oral sentence ,the oranasal sentence ,and the nasal sentence were unchanged （P〉0 .05） .Three months after surgery ,the nasalance scores of the oral sentence and the oranasal sentence were unchanged （P〉0 .05）;while the nasalance scores of the nasal sentence were significantly higher compared to pre-surgery values （P〈0 .05） .Conclu‐sion UPPP doses not affect the vocal function .But it might have a certain effect on resonance function ,demonstra‐ted by the change of several formant frequency and nasalance .UPPP in all professional voice users should be cau‐tious .Such patients who want to undergo UPPP must be informed of this potential modification of the voice after sursery .

关 键 词：悬雍垂腭咽成形术 嗓音 共振峰 鼻音率 

分 类 号：R766.9[医药卫生—耳鼻咽喉科]