首页 > 过刊浏览 > 文章详情

声带下方收敛角度在声门闭合不全发声困难中可能的作用机理

The Effect of Sub-glottal Convergence Angle on the Degree of Glottal Closure

邬晓力;徐新林;王勇;王金岸;庄佩耘;

1:厦门大学附属中山医院耳鼻咽喉科

2:厦门大学附属中山医院放射科

在线阅读

摘要

目的探讨喉三维CT重建下声带下方收敛角度的测量方法,探索声门闭合不全对声带下方收敛角度的影响,分析声门闭合不全发声疲劳可能的气流动力学原因。方法采用双源薄层CT,嘱受试者发/i:/音时扫描10例正常人的20侧声带(声门闭合组),深吸气时扫描8例单侧声带麻痹患者的麻痹侧声带(声门闭合不全组),经深吸气时扫描另10例正常人的20侧声带(声带外展组);导入影像数据于Mimics软件,构建声带及气道的3D模型,联合这两模型测量声带下方收敛角度;采用单因素方差分析,比较3组受试者声带下方收敛角度的差异;并尝试采用材料的斜截面应力分配原理进行声门下压力分析,探讨声门下收敛角度对启动发声时声带振动可能的影响。结果声门闭合组、声门闭合不全组及声带外展组的声带下方收敛角度分别为33.49°±3.75°、55.03°±2.61°及75.02°±7.32°,三组间差异有统计学意义(P<0.01),声带下方收敛角度随声门闭合不全程度增加而增加。结论声带下方收敛角度可以通过声带及气道的3D模型进行有效测量,声门闭合不全程度增加会引起该角度增大,可能会导致声门下压力作用于声带下方的剪切力和正应力的分力发生变化,从而引起发声困难。

关键词

声带;斜截面;声带下方收敛角度;声门闭合不全

基金项目(Foundation):

国家自然科学基金(NSFC81371080);; 福建省卫生系统中青年骨干人才培养项目(2013-ZQN-JC-35)资助

作者

邬晓力;徐新林;王勇;王金岸;庄佩耘;

参考文献

1郭永清,林生智,徐新林,等.空气动力学参数在嗓音功能评估中的意义[J].中华耳鼻咽喉头颈外科杂志,2012,47:858.

2 Patel R,Dailey SD.Comparison of high-speed digital imaging with stroboscopy for laryngeal imaging of glottal disorders.[J].Annals of Otology Rhinology&Laryngology,2008,117:413.

3 Khoddami SM,Nakhostin AN,Izadi F,et al.The assessment methods of laryngeal muscle activity in muscle tension dysphonia:a review[J].Thescientific World Journal,2013,2013:77.

4 Poburka BJ.A new stroboscopy rating form[J].Journal of Voice,1999,13:403.

5 Krausert CR,Olszewski AE,Taylor LN,et al.Mucosal wave measurement and visualization techniques[J].Journal of Voice,2011,25:395.

6 Hollien H.Vocal fold dynamics for frequency change[J].Journal of Voice,2014,28:395.

7 Xu X,Wang J,Devine EE,et al.The potential role of subglottal convergence angle and measurement[J].Journal of Voice,2016.

8 Boresi AP,Chong KP,Lee JD.Elasticity in engineering mechanics[M].3rd ed.Hoboken:Wiley,2010.65~225.

9 Fukuda J,Gwag JS,Yoneya M,et al.Theory of anchoring on a two-dimensionally grooved surface.[J].Physical Review E Statistical Nonlinear&Soft Matter Physics,2008,77:119.

10 Arii S,Kataoka H,Hasegawa K,et al.A study of human vocal fold vibration by means of simultaneous measurement of subglottal pressure and glottal velocity during phonation(mechanical systems)[J].Transactions of the Japan Society of Mechanical Engineers C,2009,75:2965.

11 D9llinger M,Rosanowski F,Eysholdt U,et al.Basic research on vocal fold dynamics:three-dimensional vibration analysis of human and canine larynges[J].HNO,2008,56:1213.

12 Wu W,Sun G,Sun B,et al.Modified thyroplasty for unilateral vocal fold paralysis using an adjustable titanium implant[J].European Archives of Oto-RhinoLaryngology,2015,272:517.

13 徐亮,田家凯,李传福,等.多层螺旋CT重建技术对咽喉部疾病的诊断价值[J].中华肿瘤防治杂志,2007,14:60.

本文信息

PDF(249K)

本文关键词相关文章

声带斜截面声带下方收敛角度声门闭合不全

本文作者相关文章

邬晓力徐新林王勇王金岸庄佩耘