Freedman-Doan Anya, Pereyra Maldonado Lisandra, Lowell Soren Y
Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York.
Department of Communication Sciences and Disorders, Syracuse University, Syracuse, New York.
J Voice. 2024 Sep 3. doi: 10.1016/j.jvoice.2024.08.016.
The purpose of this study was to determine hyolaryngeal kinematics during voicing in people with primary muscle tension dysphonia (pMTD) compared with healthy speakers, and to investigate the relationships between hyolaryngeal displacement and self-perceived vocal function.
Twenty-six participants, 13 with pMTD and 13 healthy speakers, were assessed using sonography during sustained vowel phonation and rest. Displacement of the hyoid bone and thyroid cartilage was measured from still frames extracted from ultrasound video recordings, with measures normalized to reflect change from rest during voicing for each participant. Vocal function was determined for all participants through self-perceived speaking effort and the Voice Handicap Index-10.
Normalized displacement of the hyoid bone and thyroid cartilage was significantly greater during voicing for participants with pMTD than for the healthy speakers. Weak-to-moderate, nonsignificant relationships between hyoid displacement and vocal function measures were evidenced, whereas moderate-to-strong, significant relationships were found for thyroid displacement and vocal function measures.
Displacement of the hyoid and elevation of the larynx during phonation appear to be prominent features of pMTD that differentiate the disorder from healthy phonatory kinematics. Ultrasound imaging provides a sensitive, reliable, noninvasive, and feasible method for objectively determining hyolaryngeal kinematics and may be useful for differential diagnosis and determination of treatment outcomes in pMTD.
本研究旨在确定原发性肌肉紧张性发声障碍（pMTD）患者与健康受试者在发声过程中的舌骨-喉运动学特征，并探讨舌骨-喉位移与自我感知的发声功能之间的关系。
26名参与者，其中13名患有pMTD，13名健康受试者，在持续元音发声和休息期间使用超声进行评估。从超声视频记录中提取的静止帧测量舌骨和甲状软骨的位移，并对测量值进行归一化处理，以反映每个参与者在发声过程中相对于休息时的变化。通过自我感知的发声努力和嗓音障碍指数-10来确定所有参与者的发声功能。
pMTD患者在发声时舌骨和甲状软骨的归一化位移明显大于健康受试者。舌骨位移与发声功能测量之间存在弱至中度、无显著意义的关系，而甲状软骨位移与发声功能测量之间存在中度至强、显著的关系。
发声时舌骨的位移和喉部的抬高似乎是pMTD的突出特征，可将该疾病与健康的发声运动学特征区分开来。超声成像为客观确定舌骨-喉运动学提供了一种敏感、可靠、无创且可行的方法，可能有助于pMTD的鉴别诊断和治疗效果的确定。
