University of Wisconsin-Madison School of Medicine and Public Health, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Madison, Wisconsin 53706, USA.
Laryngoscope. 2011 Feb;121(2):339-45. doi: 10.1002/lary.21346. Epub 2011 Jan 13.
The optimal degree of arytenoid rotation for arytenoid adduction (AA) can be determined using quantitative real-time voice analysis.
Repeated measures with each larynx serving as its own control.
Unilateral vocal fold paralysis (VFP) was modeled in five excised canine larynges. Medialization laryngoplasty (ML) was performed, followed by AA. The optimal degree of arytenoid rotation was determined using real-time measurements of vocal efficiency (V(E) ), percent jitter, and percent shimmer. After the optimal degree of rotation was determined, the arytenoid was hypo- and hyperrotated 10% ± 2% of the optimal angle to mimic hypoadducted and hyperadducted states. Aerodynamic, acoustic, and mucosal wave measurements were recorded.
Mean optimal angle of arytenoid adduction was 151.4 ± 2.5°. V(E) differed significantly across experimental conditions (P = .003). Optimal AA produced the highest V(E) of any treatment, but this value did not reach that produced in the normal condition. Percent jitter (P < .001) and percent shimmer (P < .001) differed across groups and were lowest for optimal AA. Mucosal wave amplitude of the normal (P = .001) and paralyzed fold (P = .043) differed across treatments. Amplitude of both folds was highest for optimal AA.
V(E) and perturbation parameters were sensitive to the degree of arytenoid rotation. Using real-time voice analysis may aid surgeons in determining the optimal degree of arytenoid rotation when performing AA. Testing this method in patients and determining if optimal vocal outcomes are associated with optimal respiratory and swallowing outcomes will be essential to establishing clinical viability.
通过定量实时语音分析，可以确定杓状软骨内收时杓状软骨旋转的最佳程度。
每个喉均作为自身对照的重复测量。
在 5 个切除的犬喉中建立单侧声带麻痹 (VFP)。进行杓状软骨内移术 (ML) 后，进行 AA。使用实时测量的发声效率 (V(E))、声抖动百分比和声闪烁百分比来确定最佳的杓状软骨旋转程度。确定最佳旋转程度后，将杓状软骨旋转 10%±2%的最佳角度以模拟低内收和高内收状态。记录气动、声学和黏膜波测量结果。
平均最佳杓状软骨内收角度为 151.4±2.5°。实验条件下的 V(E) 差异有统计学意义 (P=.003)。最佳 AA 产生的 V(E) 高于任何治疗方法，但未达到正常状态下的 V(E)。声抖动百分比 (P<.001) 和声闪烁百分比 (P<.001) 各组间差异有统计学意义，最佳 AA 组最低。正常 (P=.001) 和麻痹侧声带 (P=.043) 的黏膜波振幅在各组间差异有统计学意义。最佳 AA 时双侧声带的振幅最高。
V(E)和扰动量参数对杓状软骨旋转程度敏感。实时语音分析可能有助于外科医生在进行 AA 时确定最佳的杓状软骨旋转程度。在患者中测试这种方法并确定最佳的发声效果是否与最佳的呼吸和吞咽效果相关，对于确定其临床可行性至关重要。
