Thejaswi D, Alfred Rezwin M, D'Souza Florida P
Department of Audiology & Speech Language Pathology, Nitte Institute of Speech & Hearing, Medical Sciences Complex, Nithyanandanagar, Deralakatte, Mangalore, 575 018 Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2016 Sep;68(3):289-93. doi: 10.1007/s12070-015-0862-3. Epub 2015 May 29.
Resonance change is a common clinical symptom in individuals with deviated nasal septum. Often this anatomical deficit is surgically treated by septoplasty. Therefore monitoring resonance changes using acoustical tools is vital. Hence, the study investigated cepstral measure differences in subjects with deviated nasal septum compared to normals. A case-control study design involving 20 subjects within 18-40 years divided into Group I of 10 subjects with deviated nasal septum (DNS) and Group II of 10 normal subjects participated. All the subjects sustained nasalized vowel /ã/ at 10 cm mouth-microphone distance for minimum of 5 seconds. For Group I, voice sample was recorded in 2 conditions, 2 days pre-septoplasty and 1 month post-septoplasty. Cepstral peak prominence (CPP) and smooth cepstral peak prominence (CPPS) values was extracted using the Hillenbrand algorithm. Mean values revealed increased CPP and CPPS measure post-septoplasty when compared to pre-septoplasty. ANOVA showed statistically significant difference only for CPPS at p = 0.00. The higher cepstral values of post-septoplasty is due to widened nasal passage that leads to increased nasal volume, decreased acoustic damping and increased nasal patency. These changes in supraglottic chambers will result in a better acoustic space for good resonance. However, the CPPS values were not similar to normal subjects because of scarring or incomplete recovery of the outer mucosal layer of the nasal tract. Thus, we can conclude that cepstral analysis is a sensitive tool to detect resonance changes in the nasal patency.
共振变化是鼻中隔偏曲患者常见的临床症状。通常这种解剖缺陷通过鼻中隔成形术进行手术治疗。因此，使用声学工具监测共振变化至关重要。因此，本研究调查了鼻中隔偏曲患者与正常人相比的谐波倒谱测量差异。一项病例对照研究设计，纳入了18至40岁的20名受试者，分为10名鼻中隔偏曲（DNS）患者的第一组和10名正常受试者的第二组。所有受试者在口部与麦克风距离为10厘米的情况下持续发出鼻音元音/ã/至少5秒。对于第一组，在鼻中隔成形术前2天和术后1个月的2种情况下记录语音样本。使用希伦布兰德算法提取谐波峰值突出度（CPP）和平滑谐波峰值突出度（CPPS）值。平均值显示，与鼻中隔成形术前相比，术后CPP和CPPS测量值增加。方差分析显示，仅CPPS在p = 0.00时有统计学显著差异。鼻中隔成形术后谐波值较高是由于鼻腔通道变宽，导致鼻腔容积增加、声阻尼减小和鼻腔通畅度增加。声门上腔的这些变化将导致更好的声学空间以实现良好的共振。然而，由于鼻腔外粘膜层的瘢痕形成或未完全恢复，CPPS值与正常受试者不同。因此，我们可以得出结论，谐波分析是检测鼻腔通畅度共振变化的敏感工具。
