Joo Chan Uhng, Choi Yoon Mi, Kim Sun Jun
Department of Pediatric, Chonbuk National University Medical School, Jeonju, Korea.
Pediatr Int. 2015 Apr;57(2):205-9. doi: 10.1111/ped.12551. Epub 2015 Feb 24.
Hoarse or asthenic voice is frequently associated with various pediatric cardiac disorders. The aim of this study was to investigate the changes in voice physiology after surgical correction in patients with congenital heart diseases.
We performed voice analysis using induced crying of 40 infants with congenital heart disease (CHD) such as ventricular septal defect (VSD), patent ductus arteriosus (PDA), and atrial septal defect (ASD; 31 girls, 24 boys; mean age, 11 ± 8.9 months). Cries were serially recorded immediately prior to operation, then 1 week, and 1 month after surgical correction, respectively. Acoustic parameters, fundamental frequency (F0 ), duration of cry, noise to harmonic ratio (NHR), jitter, and shimmer, were extracted using Multi-Dimensional Voice Program™ (MDVP) a computerized speech analysis system. Cries were compared with 30 normal healthy infants of corresponding age.
Among the 25 infants with VSD, cry duration, jitter, and shimmer improved after the operation (P < 0.05). F0 and NHR, however, were not significantly different. F0 in patients with PDA improved, but was not statistically significant. The duration of cry, jitter, shimmer, and NHR improved in the PDA group (P < 0.05). The jitter and shimmer parameters improved significantly (P < 0.05), but F0 , cry duration, and NHR in patients with ASD did not show any significant changes.
Deviated voice patterns in pediatric patients with CHD can normalize after surgical correction. In addition, non-invasive analysis such as MDVP can be used to identify vocal paralysis, even in the early postoperative period.
声音嘶哑或无力常与多种小儿心脏疾病相关。本研究旨在调查先天性心脏病患者手术矫正后声音生理学的变化。
我们对40例患有先天性心脏病（CHD）的婴儿进行了声音分析，这些婴儿患有室间隔缺损（VSD）、动脉导管未闭（PDA）和房间隔缺损（ASD）（31名女孩，24名男孩；平均年龄11±8.9个月）。分别在手术前、手术后1周和1个月时连续记录哭声。使用计算机语音分析系统多维语音程序（MDVP）提取声学参数，包括基频（F0）、哭声持续时间、噪声谐波比（NHR）、抖动和闪烁。将哭声与30名相应年龄的正常健康婴儿进行比较。
在25例VSD婴儿中，术后哭声持续时间、抖动和闪烁有所改善（P<0.05）。然而，F0和NHR无显著差异。PDA患者的F0有所改善，但无统计学意义。PDA组的哭声持续时间、抖动、闪烁和NHR有所改善（P<0.05）。ASD患者的抖动和闪烁参数显著改善（P<0.05），但F0、哭声持续时间和NHR无显著变化。
先天性心脏病小儿患者的异常声音模式在手术矫正后可恢复正常。此外，即使在术后早期，MDVP等非侵入性分析也可用于识别声带麻痹。
