Higgins M B, Carney A E, Schulte L
Boys Town National Research Hospital, Omaha, NE.
J Speech Hear Res. 1994 Jun;37(3):510-21. doi: 10.1044/jshr.3703.510.
The purpose of this investigation was to study the impact of hearing loss on phonatory, velopharyngeal, and articulatory functioning using a comprehensive physiological approach. Electroglottograph (EGG), nasal/oral air flow, and intraoral air pressure signals were recorded simultaneously from adults with impaired and normal hearing as they produced syllables and words of varying physiological difficulty. The individuals with moderate-to-profound hearing loss had good to excellent oral communication skills. Intraoral pressure, nasal air flow, durations of lip, velum, and vocal fold articulations, estimated subglottal pressure, mean phonatory air flow, fundamental frequency, and EGG abduction quotient were compared between the two subject groups. Data from the subjects with hearing loss also were compared across aided and unaided conditions to investigate the influence of auditory feedback on speech motor control. The speakers with hearing loss had significantly higher intraoral pressures, subglottal pressures, laryngeal resistances, and fundamental frequencies than those with normal hearing. There was notable between-subject variability. All of the individuals with profound hearing loss had at least one speech/voice physiology measure that fell outside of the normal range, and most of the subjects demonstrated unique clusters of abnormal behaviors. Abnormal behaviors were more evident in the phonatory than articulatory or velopharyngeal systems and were generally consistent with vocal fold hyperconstriction. There was evidence from individual data that vocal fold posturing influenced articulatory timing. The results did not support the idea that the speech production skills of adults with moderate-to-profound hearing loss who are good oral communicators deteriorate when there are increased motoric demands on the velopharyngeal and phonatory mechanism. Although no significant differences were found between the aided and unaided conditions, 7 of 10 subjects showed the same direction of change for subglottal pressure, intraoral pressure, nasal air flow, and the duration of lip and vocal fold articulations. We conclude that physiological assessments provide important information about the speech/voice production abilities of individuals with moderate-to-profound hearing loss and are a valuable addition to standard assessment batteries.
本研究的目的是采用综合生理学方法，研究听力损失对发声、腭咽和发音功能的影响。在听力受损和听力正常的成年人发出生理难度各异的音节和单词时，同步记录了电子声门图（EGG）、鼻/口腔气流和口腔内气压信号。中重度听力损失的个体具有良好至优秀的口语交流能力。比较了两组受试者之间的口腔内压力、鼻气流、唇、软腭和声带发音的持续时间、估计的声门下压力、平均发声气流、基频和EGG外展商数。还比较了听力损失受试者在助听和未助听条件下的数据，以研究听觉反馈对言语运动控制的影响。听力损失的受试者比听力正常的受试者具有显著更高的口腔内压力、声门下压力、喉部阻力和基频。受试者之间存在显著的个体差异。所有重度听力损失的个体至少有一项言语/嗓音生理学指标超出正常范围，并且大多数受试者表现出独特的异常行为集群。异常行为在发声系统中比在发音或腭咽系统中更明显，并且通常与声带过度收缩一致。个体数据表明，声带姿态会影响发音时间。结果并不支持这样的观点，即作为良好口语交流者的中重度听力损失成年人，当腭咽和发声机制的运动需求增加时，其言语产生技能会下降。虽然在助听和未助听条件之间未发现显著差异，但10名受试者中有7名在声门下压力、口腔内压力、鼻气流以及唇和声带发音持续时间方面表现出相同的变化方向。我们得出结论，生理学评估为中重度听力损失个体的言语/嗓音产生能力提供了重要信息，是标准评估组合中有价值的补充。
