Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Marchioninistr. 15, 81377, Munich, Germany.
Freiburg Institute of Musicians' Medicine, and Medical Faculty, Freiburg University, Elsässerstr. 2, 79114, Freiburg, Germany.
Eur Arch Otorhinolaryngol. 2020 Jul;277(7):1995-2003. doi: 10.1007/s00405-020-05887-y. Epub 2020 Mar 14.
Semi-occluded vocal tract exercises, such as water resistance therapy (WRT), are widely used in voice therapy. However, the potential positive effects of such a therapy on vocal fold oscillation patterns in patients indicating a need for phonomicrosurgery have not yet been explored. The presented study aims to analyze the effect of WRT in patients suffering from vocal fold mass lesions.
Eight participants with vocal fold mass lesions were asked to sustain a phonation on the vowel /i/ at a comfortable loudness and a fundamental frequency of 250 Hz (females) or 125 Hz (males). During phonation the subjects were simultaneously recorded with transnasal high-speed videoendoscopy (HSV, 20.000 fps), electroglottography, and audio signals. These subjects then performed a WRT (phonation in a silicone tube of 30 cm length, 5 cm below the water surface) for 10 min. Repeated measurements of sustained phonation were performed 0, 10, and 30 min after exercising. From the HSV data the glottal area waveform (GAW) was segmented and GAW parameters were computed.
During WRT there was an increase of the GAW related open quotient and closing quotient. Immediately after WRT, there was a drop of both values followed by a rise of these parameters up to 30 min after the intervention. Furthermore, there was no correlation between GAW and electroglottographical open quotients.
The effects observed after a single session of WRT on participants with vocal fold mass lesions showed a similar pattern to vocal fatigue.
半闭塞声道练习，如水中发声练习（WRT），广泛应用于嗓音治疗。然而，这种治疗对需要行显微嗓音手术的声带病变患者的声带振动模式的潜在积极影响尚未得到探索。本研究旨在分析 WRT 对声带肿块病变患者的影响。
8 名声带肿块病变患者被要求在舒适的响度和 250Hz（女性）或 125Hz（男性）的基频下持续发/i/元音。在发声过程中，受试者同时通过经鼻高速视频内窥镜（HSV，20000fps）、声门图和音频信号进行记录。然后，这些受试者进行 10 分钟的 WRT（在长度为 30cm、水面下 5cm 的硅树脂管中发声）。在锻炼后 0、10 和 30 分钟重复进行持续发声的测量。从 HSV 数据中分割出声门区波形（GAW），并计算 GAW 参数。
在 WRT 过程中，GAW 的开放商和闭合商增加。WRT 后即刻，这两个值下降，随后这些参数上升，直到干预后 30 分钟。此外，GAW 与声门图的开放商之间没有相关性。
单次 WRT 对声带肿块病变患者的影响与声带疲劳相似。
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