Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware.
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
J Voice. 2022 Sep;36(5):673-684. doi: 10.1016/j.jvoice.2020.08.040. Epub 2020 Nov 7.
Impaired respiratory function could potentially explain why some older speakers experience voice-related handicap whereas others do not, despite presenting with similar age-related laryngeal characteristics. The objectives of this study were therefore to (1) describe voice and respiratory function across men and women in a sample of treatment-seeking patients with presbyphonia; (2) assess how respiratory function differed from the general elderly population, based on normative data; and 3) discuss how respiratory function may play a role in the development of voice symptoms across men and women.
Twenty one participants with presbyphonia underwent respiratory assessments (spirometry and respiratory muscle strength testing) in addition to standard of care voice assessments. Respiratory variables included forced vital capacity (FVC), forced expiratory volume in one second (FEV), FEV/FVC, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP).
Voice features were consistent with the diagnosis of presbyphonia and values did not different significantly between males and females, although some trends were noted. Regarding respiratory variables, one-third of the participants (n = 7) presented with FVC and FEV less than 80% of predicted, and 57% (n = 12) were <90% of predicted. Nine percent of the males (n = 1) and none of the females had a MIP below the lower limit of normal (LLN) expected for their age, sex, and weight. Eighteen percent of the males (n = 2) and 20% of the females (n = 2) fell below the LLN for MEP.
Our sample of participants with presbyphonia included a non-negligible proportion of patients with decreased percent predicted values of FVC and FEV, and with respiratory muscle strength (MEP) below the LLN. Standardized values of pulmonary function were not different across sexes, indicative of a similar respiratory health. However, a lower raw pulmonary function and respiratory muscle strength in women may compound laryngeal changes and have an impact on perceived voice-related handicap. Together, findings warrant further studies to explore the impact of decreased respiratory function on voice and, ultimately, on the response to voice therapy in patients with presbyphonia.
呼吸功能受损可能是导致一些老年患者出现与声音相关的障碍,而另一些患者尽管喉部出现了与年龄相关的相似变化,却没有出现这些障碍的原因之一。本研究的目的因此是:(1)描述在寻求治疗的、患有老化性嗓音障碍的患者样本中,男女之间的嗓音和呼吸功能情况;(2)根据常模数据,评估呼吸功能与一般老年人群之间的差异;(3)探讨呼吸功能如何在男女患者的嗓音症状发展中发挥作用。
21 名患有老化性嗓音障碍的患者除了进行标准的嗓音评估外,还进行了呼吸评估(肺活量测定和呼吸肌力量测试)。呼吸变量包括用力肺活量(FVC)、一秒用力呼气量(FEV)、FEV/FVC、最大吸气压力(MIP)和最大呼气压力(MEP)。
嗓音特征与老化性嗓音障碍的诊断相符,且男性和女性之间的数值没有显著差异,尽管存在一些趋势。关于呼吸变量,有三分之一的参与者(n=7)的 FVC 和 FEV 值低于预计值的 80%,57%(n=12)的 FVC 和 FEV 值低于预计值的 90%。有 9%的男性(n=1)和没有女性的 MIP 值低于其年龄、性别和体重预期的正常下限(LLN)。有 18%的男性(n=2)和 20%的女性(n=2)的 MEP 值低于 LLN。
我们的老化性嗓音障碍患者样本中,有相当一部分患者的 FVC 和 FEV 的预计百分比值降低,呼吸肌力量(MEP)低于 LLN。各性别之间的肺功能标准值没有差异,表明呼吸健康状况相似。然而,女性的肺功能和呼吸肌力量原始值较低,可能会加剧喉部变化,并对感知到的与声音相关的障碍产生影响。总之,这些发现需要进一步的研究来探索呼吸功能下降对声音的影响,并最终对老化性嗓音障碍患者的语音治疗反应产生影响。