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双颌正颌手术对骨性 III 类畸形患者嗓音特征的影响:声学分析评估。

The Effect of Bimaxillary Orthognathic Surgery on Voice Characteristics in Skeletal Class 3 Deformity Patients: An Evaluation Using Acoustic Analysis.

机构信息

Student Research Committee, Faculty of Dentistry.

Department of Speech Pathology, Paramedical Sciences Faculty.

出版信息

J Craniofac Surg. 2021 Sep 1;32(6):2129-2133. doi: 10.1097/SCS.0000000000007479.

Abstract

The aim of this study was to analyze the effects of bimaxillary orthognathic surgery on the acoustic voice characteristics of skeletal class 3 patients. All healthy nonsyndromic patients with Class 3 deformity who were eligible for bimaxillary orthognathic surgery, were included in this before and after quasi-experimental study. This experiment's main intervention was mandibular setback surgery by bilateral sagittal split osteotomy plus maxillary advancement using LeFort 1 osteotomy. Age, sex, and intraoperative jaw movements were recorded. Acoustic analysis of voice samples (vowels /a/ and /i/) was performed with Praat software as outcome variables. The formant frequencies (F0, F1, F2, and F3) of these vowels were extracted 1 week preoperatively (T0), 1 and 6 months (T1, T2) postoperatively by a speech therapist. The significance level was set at 0.05 using SPSS 19. The study sample comprised 20 patients including 11 women (55%) and 9 men (45%) with a mean age of 31.95 ± 4.72 years. The average mandibular setback and maxillary advancement were 3.30 ± 0.86 and 2.85 ± 0.74 mm, respectively. The fundamental frequency (F0) and the first, second, and third formants (F1, F2, F3) of vowels /i/ and /a/ were significantly decreased over time intervals, postoperatively (P < 0.05). The finding revealed that bimaxillary orthognathic surgery (maxillary advancement and mandibular setback with bilateral sagittal split osteotomy) might reduce the acoustic formant parameters of voice to the normal frequency ranges, in patients with class 3 skeletal deformities. More clinical trials with greater sample sizes and long-term follow-ups are suggested in the future.

摘要

本研究旨在分析双颌正颌手术对骨性 III 类患者的声学嗓音特征的影响。所有符合双颌正颌手术适应证的健康非综合征性 III 类畸形患者均纳入本项前瞻性准实验研究。本实验的主要干预措施为双侧矢状劈开截骨后退下颌骨并采用 LeFort 1 截骨术前徙上颌骨。记录年龄、性别和术中颌骨运动。使用 Praat 软件对嗓音样本(元音 /a/和/i/)进行声学分析作为结果变量。由言语治疗师在术前 1 周(T0)、术后 1 个月(T1)和 6 个月(T2)提取这些元音的共振峰频率(F0、F1、F2 和 F3)。使用 SPSS 19 统计软件,设定显著性水平为 0.05。研究样本包括 20 例患者,其中女性 11 例(55%),男性 9 例(45%),平均年龄 31.95±4.72 岁。下颌骨后退和上颌骨前徙的平均距离分别为 3.30±0.86 和 2.85±0.74 mm。元音/i/和/a/的基频(F0)和第一、第二、第三共振峰(F1、F2、F3)随时间间隔在术后显著降低(P<0.05)。结果表明,双颌正颌手术(双侧矢状劈开截骨后退下颌骨并采用 LeFort 1 截骨术前徙上颌骨)可能会降低 III 类骨骼畸形患者的嗓音声学共振峰参数至正常频率范围。建议未来进行更多具有更大样本量和长期随访的临床试验。

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