Emory University School of Medicine, Emory Voice Center, Atlanta, Georgia.
Oncology Rehab, Centennial, Colorado.
J Voice. 2022 Mar;36(2):183-193. doi: 10.1016/j.jvoice.2020.05.011. Epub 2020 Jun 23.
Semioccluded vocal tract (SOVT) exercises are routinely included in many voice therapy programs because they have been shown to improve acoustic, aerodynamic, and patient-reported voice outcomes. One limitation of the traditional SOVT exercise is that the nature of phonation through straws or semioccluded oral postures allows only for single phoneme production. A variably occluded facemask (VOFM) allows for use of articulated connected speech beyond the production of single phonemes, while still providing occlusion and, presumably, the vocal efficiency benefits that arise from it. This study reports on the effect of time duration of phonation with a variably occluded facemask on voice outcomes in patients with voice disorders.
Prospective, randomized cohort study.
Fifteen patients with voice disorders phonated for 5 minutes through a VOFM with diameter openings of 3.2, 6.4, and 9.6 mm. Acoustic and aerodynamic voice measures were collected before and after each occlusion trial. These results were compared to a historical patient group that received the same phonation training for 2 minutes.
Positive effect sizes were found for acoustic and aerodynamic improvements for all patients for at least one occlusion diameter. Effect sizes for aerodynamic outcomes were greater in the 5-minute conditions for both the 9.6- and 6.4-mm occlusions than the 2-minute condition. Effect sizes for acoustic outcomes were greater in the 5 minute than 2-minute trial for the 9.6- and 6.4-mm occlusion diameter, but greater in the 2 minute than 5-minute trial for 3.2-mm diameter.
This study provides evidence that all three occlusion sizes may elicit beneficial changes for different patients; however, 5 minutes of phonation into a facemask with end occlusion of 6.4-mm diameter results in improved acoustic and aerodynamic voice outcomes for many patients with voice disorders. Future studies should further explore phonatory physiologic changes of the VOFM in a larger sample of patients and translate effects into clinical treatment for patients with voice disorders.
半闭塞声道（SOVT）练习通常包含在许多语音治疗计划中，因为它们已被证明可以改善声学、气动和患者报告的语音效果。传统 SOVT 练习的一个限制是，通过吸管或半闭塞口腔姿势发声的性质只允许单个音素的产生。可变闭塞面罩（VOFM）允许在产生单个音素之外使用发音的连续言语，同时仍然提供闭塞，并可能从中获得发声效率的益处。本研究报告了通过可变闭塞面罩发声时间对嗓音障碍患者的嗓音结果的影响。
前瞻性、随机队列研究。
15 名嗓音障碍患者通过直径为 3.2、6.4 和 9.6 毫米的 VOFM 发声 5 分钟。在每次闭塞试验前后收集声学和气动语音测量值。将这些结果与接受相同发音训练 2 分钟的历史患者组进行比较。
所有患者在至少一个闭塞直径下均发现声学和气动改善的正效应量。对于气动结果，在 5 分钟条件下，9.6 和 6.4 毫米的闭塞的效应量大于 2 分钟条件，而对于声学结果，在 9.6 和 6.4 毫米的闭塞直径下，5 分钟试验的效应量大于 2 分钟试验，而在 3.2 毫米直径下，2 分钟试验的效应量大于 5 分钟试验。
本研究提供了证据，表明所有三种闭塞尺寸都可能为不同的患者引起有益的变化；然而，对于许多嗓音障碍患者，用 6.4 毫米直径末端闭塞的面罩进行 5 分钟的发声可导致声学和气动语音效果的改善。未来的研究应进一步探索 VOFM 在更大的患者样本中的发音生理变化，并将效果转化为嗓音障碍患者的临床治疗。
