Karaoğullarından Ayşe, Erkan Sanem Okşan
ENT Specialist in Adana City Training and Research Hospital, ENT Department, Yüreğir, Adana, Turkey.
ENT Specialist in Adana City Training and Research Hospital, ENT Department, Yüreğir, Adana, Turkey.
J Voice. 2025 Jan;39(1):288.e1-288.e7. doi: 10.1016/j.jvoice.2022.06.027. Epub 2022 Aug 13.
Inflammation of the upper airways, thickening of the lateral pharyngeal walls, elongation of the soft palate and uvula, hypertrophy of the tonsils and base of the tongue can be seen in obstructive sleep apnea syndrome patients. Changes in these structures may affect articulation and phonation, negatively affecting the quality of the voice. Positive airway pressure (PAP) treatment reduces the volume of the root of the tongue, dissolves the edema in the upper respiratory tract, increases the posterior pharyngeal area, and positively changes the quality of the voice.
A total of 151 people, 50 control group, and 101 patients, were included in the study between December 2020 and December 2021. The patient group was divided into two groups as continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP) users. All voice recordings were made in the control group and the patient group before and 3 months after CPAP and BPAP treatment, and were evaluated with the Praat (Paul, 2001) voice analysis program. The fundamental frequency of the sound (F0), frequency perturbation (jitter), amplitude perturbation (shimmer), noise-to-harmonic ratio (NHR) values were evaluated in the patient and control groups, and they were compared with each other before and after the treatment in the CPAP and BPAP groups.
Before and after PAP treatment; the changes in F0, Jitter, Shimmer, and NHR in the CPAP and BPAP group were statistically significant (P < 0.05). While the F0 change before and after PAP treatment was the most in the CPAP group, the jitter, shimmer and NHR changes were the most in the BPAP group.
Regular 3-month PAP treatment positively affects F0, jitter, shimmer and NHR values. The greatest F0 change is in the use of CPAP, the improvement in jitter, shimmer and NHR is the most in the use of BPAP.
阻塞性睡眠呼吸暂停综合征患者可见上呼吸道炎症、咽侧壁增厚、软腭和悬雍垂延长、扁桃体和舌根肥大。这些结构的变化可能会影响发音和发声,对嗓音质量产生负面影响。持续气道正压通气(PAP)治疗可减小舌根体积,消除上呼吸道水肿,增加咽后区面积,并对嗓音质量产生积极改变。
2020年12月至2021年12月期间,共有151人纳入研究,其中50人为对照组,101人为患者组。患者组分为持续气道正压通气(CPAP)使用者和双水平气道正压通气(BPAP)使用者两组。对照组和患者组在CPAP和BPAP治疗前及治疗3个月后均进行了嗓音录音,并使用Praat(Paul,2001)嗓音分析程序进行评估。对患者组和对照组的声音基频(F0)、频率微扰(抖动)、幅度微扰(闪烁)、噪声谐波比(NHR)值进行评估,并在CPAP和BPAP组治疗前后相互比较。
PAP治疗前后;CPAP组和BPAP组的F0、抖动、闪烁和NHR变化具有统计学意义(P<0.05)。PAP治疗前后F0变化在CPAP组中最大,而抖动、闪烁和NHR变化在BPAP组中最大。
为期3个月的定期PAP治疗对F0、抖动、闪烁和NHR值有积极影响。使用CPAP时F0变化最大,使用BPAP时抖动、闪烁和NHR改善最明显。