语谱图在鼻内镜术后语音特征评估中的应用  

The application of spectrogram in the evaluation of postoperative articulation characteristics under nasal endoscopy

作　　者：刘雪莱 陈知己 刘恒鑫 方红雁 胡娅琴 李晓晓 陈红江 LIU Xuelai;CHEN Zhiji;LIU Hengxin;FANG Hongyan;HU Yaqin;LI Xiaoxiao;CHEN Hongjiang(Department of Otolaryngology,Chongqing General Hospital,Chongqing 400014,China;Department of Otola-ryngology,Head and Neck Surgery,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]重庆市人民医院耳鼻咽喉头颈外科,重庆400014 [2]国家儿童医学中心/首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,北京100045

出　　处：《听力学及言语疾病杂志》2025年第2期124-129,共6页Journal of Audiology and Speech Pathology

基　　金：重庆市科卫联合医学科研项目(2022QNXM004)。

摘　　要：目的探讨鼻内镜术后患者语音特征的客观变化,并分析手术与声道结构变化的关系。方法前瞻性纳入2023年6~12月行鼻内镜手术患者45例,其中鼻中隔偏曲矫正术和/或鼻息肉切除术和/或鼻甲成形术组(G1组)13例,单纯鼻窦开放术组(G2组)11例,鼻窦开放+鼻中隔偏曲矫正术和/或鼻息肉切除术和/或鼻甲成形术组(G3组)21例。三组均在术前和术后1月完善语谱图检测,分析不同声任务(口化元音、鼻化元音及含鼻元音的词组和短句)下的鼻阻力(Refft值)、声学指标共振峰频率(F1~F4)、带宽(bandwidths,B1~B4)、F1振幅与鼻杂音共振峰振幅的差值(A1-P0)及F1振幅与鼻共振峰振幅的差值(A1-P1)。结果各组术后嗓音声学指标无明显改变,Refft值均显著下降,口化元音共振峰变化不明显,但带宽多显著下降。各组术后A1-P1均存在上升趋势,A1-P0均存在下降趋势。其中,G1组A1-P1在发/ma/、/na/、/mi/、/ni/时较术前明显上升;A1-P0在发/ma/、/na/时较术前明显下降;G2组A1-P0在发/ma/、/na/时较术前明显下降;G3组A1-P1在发/mi/、/ni/时较术前明显上升;A1-P0在发/ma/、/na/时较术前明显下降。结论鼻内镜手术会对患者语音产生可测量的影响。语谱图可用于鼻内镜术后发音特征的评估,其中A1-P1对于高元音/i/、A1-P0对于非高元音/a/是更好的测量指标。Objective To study the objective changes and effects of speech characteristics in patients with nasal endoscopic surgery,and to analyze the relationship between surgery and changes in vocal tract structure.Methods A prospective study was conducted on 45 patients who underwent nasal endoscopic surgery from June 2023 to December 2023.Among them,13 patients underwent nasal septum deviation correction surgery and/or nasal polypectomy and/or turbinate shaping surgery group(G1 group),11 patients underwent simple sinus opening surgery group(G2 group),and 21 patients underwent nasal sinus opening+nasal septum deviation correction surgery and/or nasal polypectomy and/or nasal turbinate shaping surgery group(G3 group).Spectrogram detection was completed before and 1 month after surgery.Nasal resistance(Refft value),acoustic indicators resonance peak frequency(F1-F4),bandwidth(B1-B4),difference between F1 amplitude and nasal murmur resonance peak amplitude(A1-P0),and difference between F1 and nasal murmur resonance peak amplitude(A1-P1)under different sound tasks(oral vowels,nasal vowels,and phrases and short sentences containing nasal vowels)were analyzed.Results After surgery,there was no significant change in the acoustic indicators in any of the groups,and the Refft value significantly decreased.The change in the resonance peak of oral vowels was not significant,but the bandwidth significantly decreased.A1-P1 in each group showed an upward trend after surgery,while A1-P0 showed a downward trend after surgery.Among them,A1-P1 in G1 group showed a significant increase compared to preoperative levels in/ma/,/na/,/mi/,and/ni/,and A1-P0 showed a significant decrease in/ma/and/na/compared to preoperative levels.There were statistically significant differences in A1-P0 between G2 group and preoperative group in both/ma/and/na/.The A1-P1 levels in G3 group showed significant differences compared to preoperative levels in/mi/and/ni/,and A1-P0 showed significant differences compared to preoperative levels in/ma/and/na/.Conclusion

关 键 词：鼻内镜手术 语音特征 语谱图 

分 类 号：R76[医药卫生—耳鼻咽喉科]