肌紧张性发声障碍的临床特征及嗓音声学评估

Clinical Characteristics and Acoustics Evaluation in Patients with Muscular Tension Dysphonia

徐洁洁;陆美萍;陈曦;王娟;

1:南京医科大学第一附属医院耳鼻咽喉科

摘要

目的观察肌紧张性发声障碍(muscular tension dysphonia,MTD)患者的临床特点,探讨喉镜检查及计算机嗓音声学检测技术在此类发声障碍诊断中的应用价值。方法观察46例MTD患者发声特点及颈部体征,采用电子喉镜和计算机嗓音声学测试系统对46例MTD患者和40例正常成人进行检查,分析评估MTD患者临床表现、喉镜图像及嗓音声学特征。结果MTD患者发声呈过强、挤压、粗糙、嘶哑等特点;发声时呼吸表浅、颈部肌肉紧张、颈静脉怒张、喉结上移。喉镜显示喉腔缩小、声门前后径缩短、声门暴露差等,声带外观正常,张力增加,闭合过紧,假声带代偿性内收。嗓音声学检测显示患者嗓音具有正常和病理声学特征交替出现的特点。其特征为频率微扰(jitter)、振幅微扰(shi mmer)数值较正常升高(P<0.05),标准化噪声能量(NNE)变化不明显(P>0.05),声谱图高频区谐波及第2、3共振峰不规则、不连续、波纹抖动或消失。结论MTD患者发声过强及颈部肌肉紧张。喉镜检查声门过度闭合、声带正常。能检测到正常jitter、shi mmer、NNE及声谱图。

关键词

发声障碍;喉镜;声学分析;声谱图

基金项目(Foundation):

江苏省科委国际合作科研基金资助项目(编号DE9903)

作者

徐洁洁;陆美萍;陈曦;王娟;

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