不同腭咽闭合类型对嗓音障碍的影响  

Influence of palatopharyngeal closure type on voice disorders

作　　者：郭志焱 庞艺施[2] 梁姗姗[3] 李增宏 黄炳谕 李家豪 甘凌霄 刘莹[3] GUO Zhiyan;PANG Yishi;LIANG Shanshan;LI Zenghong;HUANG Bingyu;LI Jiahao;GAN Lingxiao;LIU Ying(the First Clinical Medical College of Guangxi Medical University,Nanning 530021,China;Department of Otolaryngology Head and Neck Surgery,the First People’s Hospital of Foshan City,Foshan 528000,China;Department of Rehabilitation Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一临床医学院,广西南宁530021 [2]佛山市第一人民医院咽喉头颈外科,广东佛山528000 [3]广西医科大学第一附属医院康复医学科,广西南宁530021

出　　处：《中国耳鼻咽喉颅底外科杂志》2024年第4期70-74,共5页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：国家自然科学基金资助项目(81901394)。

摘　　要：目的观察在电子鼻咽镜下不同腭咽闭合类型对于嗓音障碍患者严重程度的影响。方法随机选取2021年1-2月佛山市第一人民医院咽喉头颈外科门诊收治的32例患者。按发“a”音时腭咽闭合的分类不同,分为两组,一组为腭咽闭合Ⅲ型,另一组为腭咽闭合其他类型。依据嗓音障碍指数量表(VHI)-12、嗓音嘶哑分级(GRBAS)的评分和腭咽闭合不全率分析患者存在嗓音障碍的情况。结果腭咽闭合Ⅲ型组的VHI和GRBAS总评分显著高于其他类型组(P<0.05)。在GRBAS 5个方面的评分中,腭咽闭合Ⅲ型组的粗糙度(R)评分更高(P<0.05)。对VHI中情感、功能、生理3个方面的评分比较中,腭咽闭合Ⅲ型组的情感、功能评分更高(P<0.05);生理方面两组比较无差异。腭咽闭合Ⅲ型组较其他类型组表现出更高的腭咽闭合不全率(P<0.05)。结论腭咽闭合Ⅲ型的患者表现出明显的嗓音障碍,通过电子鼻咽镜观察嗓音障碍患者腭咽闭合类型,为患者嗓音障碍的评估和进行口、鼻共鸣等嗓音言语治疗提供有力的证据。Objective To observe the influence of velopharyngeal closure type under electronic nasopharyngoscope on the severity of voice disorders.Methods Thirty-two patients admitted to the Department of Otolaryngology Head and Neck Surgery of the First People’s Hospital of Foshan City from Jan 2021 to Feb 2021 were randomly selected.According to the type of velopharyngeal closure at the time with“a”sound,they were divided into two groups,one group with velopharyngeal closure typeⅢ,and the other group with other types of closure.The voice disorder was analyzed according to the voice handicap index(VHI)-12,the grade,roughness,breathiness,asthenia and strain(GRBAS)scale and the rate of velopharyngeal insufficiency.Results The total scores of VHI and GRBAS in the group with velopharyngeal closure typeⅢwere significantly higher than those in the other groups(P<0.05).In the five GRBAS scores,the roughness score in the group with velopharyngeal closure typeⅢwas higher than that in the other group(P<0.05).The scores of emotion and function in the group with velopharyngeal closure typeⅢwere higher than those in the other groups(P<0.05),while the difference in physiology between the two groups was statistically insignificant.The group with velopharyngeal closure typeⅢhad a higher rate of velopharyngeal insufficiency than the other group(P<0.05).Conclusions Patients with typeⅢvelopharyngeal closure show significant voice disorders.To observe the type of velopharyngeal closure via electronic nasopharyngoscope in patients with voice disorders may provide strong evidences for the assessment of voice disorders and voice speech therapy such as oral and nasal resonance.

关 键 词：腭咽闭合 嗓音障碍 电子鼻咽镜 发音 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]