发音阈压的再探讨：固有喉内肌激活的影响。
Phonation Threshold Pressure Revisited: Effects of Intrinsic Laryngeal Muscle Activation.
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.
出版信息
Laryngoscope. 2022 Jul;132(7):1427-1432. doi: 10.1002/lary.29944. Epub 2021 Nov 16.
OBJECTIVES/HYPOTHESIS: Phonation threshold pressure (P ) is the minimum subglottic pressure required to reach phonation onset and is considered a marker for vocal efficiency and health. We investigated the effects of intrinsic laryngeal muscle (ILM) activation on P .
STUDY DESIGN
In vivo animal study.
METHODS
In an in vivo canine phonation model, laryngeal adductor muscles were activated together by stimulation of the recurrent laryngeal nerves (RLNs) and individually via stimulation of respective terminal nerve branches. Cricothyroid (CT) muscles were activated via stimulation of the superior laryngeal nerves. ILMs were activated in a graded manner at various combinations as transglottal airflow was gradually increased. Aerodynamic and glottal posture parameters were measured at phonation onset.
RESULTS
Graded RLN stimulation decreased glottal distance and increased P . Thyroarytenoid (TA) muscle activation alone increased P . Lateral cricoarytenoid (LCA) muscle activation alone had minimal effects. However, graded TA activation as a function of LCA activation level revealed a synergistic relationship between the two muscles in increasing P . Effects of CT activation were dependent on adductor stimulation level: CT activation increased P at low RLN stimulation levels and decreased P at high RLN levels.
CONCLUSIONS
The effects of ILM activation on P were consistent with their expected effects on vocal fold stiffness and tension. TA was the primary adductor controlling P . While LCA alone had minimal effects on P , it enhanced the role of TA in controlling P . TA and CT have antagonistic roles in controlling P . These relationships should be considered in clinical efforts to improve ease of phonation and vocal efficiency.
LEVEL OF EVIDENCE
NA, basic science Laryngoscope, 132:1427-1432, 2022.
目的/假设：声门启闭压（P ）是达到发声起始所需的最小声门下压，被认为是发声效率和健康的标志。我们研究了内在喉肌（ILM）激活对 P 的影响。
研究设计
体内动物研究。
方法
在体内犬类发声模型中，通过刺激喉返神经（RLN）共同激活喉内收肌，通过刺激各自的终末神经分支分别单独激活。通过刺激上喉神经激活环甲肌（CT）。当跨声门气流逐渐增加时，以不同的组合逐渐激活 ILM。在发声起始时测量气动和声门姿势参数。
结果
分级 RLN 刺激降低了声门距离并增加了 P 。单独激活甲状杓肌（TA）增加了 P 。单独激活外侧杓状软骨肌（LCA）的影响最小。然而，随着 LCA 激活水平的增加，分级 TA 激活显示出这两块肌肉在增加 P 方面的协同关系。CT 激活的效果取决于内收肌刺激水平：在 RLN 刺激水平较低时，CT 激活增加 P ，而在 RLN 水平较高时，CT 激活降低 P 。
结论
ILM 激活对 P 的影响与其对声带僵硬和张力的预期影响一致。TA 是控制 P 的主要内收肌。虽然 LCA 单独对 P 的影响较小，但它增强了 TA 在控制 P 方面的作用。TA 和 CT 在控制 P 方面具有拮抗作用。在改善发声容易度和发声效率的临床努力中，应考虑这些关系。
证据水平
NA，基础科学喉镜，132：1427-1432，2022 年。
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