Umatani Masanori, Ogawa Makoto, Hosokawa Kiyohito, Kato Chieri, Okajima Eri, Iwahashi Toshihiko, Inohara Hidenori
Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan; Department of Otorhinolaryngology, JCHO Osaka Hospital, Osaka, Japan.
J Voice. 2023 May;37(3):470.e7-470.e16. doi: 10.1016/j.jvoice.2021.02.001. Epub 2021 Mar 8.
This study aimed to assess the feasibility of gastroesophageal manometry for continuously evaluating the degree of expiratory effort by measuring the pressures in the digestive tract during crescendo phonation.
Each of 18 healthy nondysphonic speakers had a probe with a four-channel gastroesophageal manometer inserted through the nasal cavity to place four pressure sensors in the hypopharynx, cervical-/thoracic esophagus, and stomach, and was asked to gradually increase the vocal loudness during sustained phonation of the vowel /e:/ (vowel-crescendo task), while the sound pressure level and the pressures were simultaneously recorded.
50% of the successful vowel-crescendo task samples with a gradual and adequate sound pressure level increase showed a concomitant gradual increase in both the intra-thoracic-esophageal/intra-gastric pressure values from approximately -5 mmHg /6 mmHg to -10 mmHg/20 mmHg, respectively. The maximum pressure value was the highest in the intra-gastric pressure followed by the intra-thoracic-esophageal and intra-cervical-esophageal pressures in order. However, most of the samples showed less than one of atypical pressure changes, such as fluctuations in the intra-thoracic-esophageal and intra-gastric pressure changes and dispersion in the intra-cervical-esophageal and intra-hypopharyngeal pressure values (perhaps due to the peristaltic motions, and the contact of the sensors to the membranous wall).
These results show that, during successful crescendo phonation, gastroesophageal manometry reveals a gradual increase in the intra-thoracic and intra-abdominal pressures with increasing the vocal intensity, even though showing some systematic errors, suggesting the usefulness of gastroesophageal manometry for continuously evaluating the degree of expiratory effort without influence by the laryngeal condition.
本研究旨在通过测量渐强发声过程中消化道压力，评估食管测压连续评估呼气用力程度的可行性。
18名健康无发声障碍的受试者，每人通过鼻腔插入一个带有四通道食管测压探头，将四个压力传感器分别置于下咽、颈段/胸段食管和胃内，并要求受试者在持续发元音/e:/时逐渐提高声音响度（元音渐强任务），同时记录声压级和压力。
50%成功完成元音渐强任务且声压级逐渐适度增加的样本显示，胸段食管内/胃内压力值同时逐渐增加，分别从约-5 mmHg /6 mmHg增至-10 mmHg/20 mmHg。最大压力值在胃内压力中最高，其次依次为胸段食管内压力和颈段食管内压力。然而，大多数样本显示出少于一种非典型压力变化，如胸段食管内和胃内压力变化波动以及颈段食管内和下咽内压力值离散（可能由于蠕动运动以及传感器与膜壁的接触）。
这些结果表明，在成功的渐强发声过程中，食管测压显示随着声音强度增加，胸内和腹内压力逐渐升高，尽管存在一些系统误差，这表明食管测压在不受喉部状况影响的情况下连续评估呼气用力程度具有实用性。
