Sumita Y I, Hattori M, Murase M, Elbashti M E, Taniguchi H
Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
J Oral Rehabil. 2018 Mar;45(3):216-221. doi: 10.1111/joor.12595. Epub 2017 Dec 21.
Among the functional disabilities that patients face following maxillectomy, speech impairment is a major factor influencing quality of life. Proper rehabilitation of speech, which may include prosthodontic and surgical treatments and speech therapy, requires accurate evaluation of speech intelligibility (SI). A simple, less time-consuming yet accurate evaluation is desirable both for maxillectomy patients and the various clinicians providing maxillofacial treatment. This study sought to determine the utility of digital acoustic analysis of vowels for the prediction of SI in maxillectomy patients, based on a comprehensive understanding of speech production in the vocal tract of maxillectomy patients and its perception. Speech samples were collected from 33 male maxillectomy patients (mean age 57.4 years) in two conditions, without and with a maxillofacial prosthesis, and formant data for the vowels /a/,/e/,/i/,/o/, and /u/ were calculated based on linear predictive coding. The frequency range of formant 2 (F2) was determined by differences between the minimum and maximum frequency. An SI test was also conducted to reveal the relationship between SI score and F2 range. Statistical analyses were applied. F2 range and SI score were significantly different between the two conditions without and with a prosthesis (both P < .0001). F2 range was significantly correlated with SI score in both the conditions (Spearman's r = .843, P < .0001; r = .832, P < .0001, respectively). These findings indicate that calculating the F2 range from 5 vowels has clinical utility for the prediction of SI after maxillectomy.
在接受上颌骨切除术后患者所面临的功能障碍中,言语障碍是影响生活质量的一个主要因素。言语的适当康复,可能包括口腔修复和外科治疗以及言语治疗,需要对言语可懂度(SI)进行准确评估。对于上颌骨切除患者以及提供颌面治疗的各类临床医生而言,都需要一种简单、耗时少且准确的评估方法。本研究旨在基于对上颌骨切除患者声道中语音产生及其感知的全面理解,确定元音的数字声学分析在上颌骨切除患者SI预测中的效用。从33名男性上颌骨切除患者(平均年龄57.4岁)身上采集了两种情况下的语音样本,一种是未佩戴颌面修复体,另一种是佩戴了颌面修复体,基于线性预测编码计算了元音/a/、/e/、/i/、/o/和/u/的共振峰数据。通过最低频率和最高频率之间的差异来确定共振峰2(F2)的频率范围。还进行了SI测试,以揭示SI得分与F2范围之间的关系,并应用了统计分析。未佩戴修复体和佩戴修复体这两种情况下的F2范围和SI得分存在显著差异(均P <.0001)。两种情况下F2范围均与SI得分显著相关(斯皮尔曼相关系数r分别为.843,P <.0001;r =.832,P <.0001)。这些研究结果表明,通过计算5个元音的F2范围对上颌骨切除术后的SI预测具有临床效用。