基于喉肌电图定量分析的声带麻痹患者嗓音功能评估

Quantitative Evaluation of Vocal Function in Vocal Fold Paralysis Patients Based on LEMG Analysis

摘要:

【摘要】目的 探究喉肌电图募集相转折数与嗓音声学评估参数之间的相关性,评估喉肌电图募集相转折数在声带麻痹患者嗓音功能评估中的应用价值,以全面评估声带麻痹患者嗓音状况,并指导治疗决策。方法 回顾性分析2023年10月至2024年12月于山西医科大学第一医院耳鼻咽喉头颈外科确诊为单侧声带麻痹的51例患者。根据喉肌电图结果将患者分为喉上神经功能异常组和喉返神经功能异常组,所有患者接受嗓音声学分析(基频、基频微扰、振幅微扰、最大发音时间、嗓音障碍严重程度指数)和喉肌电图检查,测量健患侧喉内肌募集相转折数。结果 喉上神经与喉返神经功能异常组健患侧转折数差异具有显著统计学意义(P＜0.001)。随着嘶哑声(H)评分增加,喉返神经功能异常组和喉上神经功能异常组的基频微扰和振幅微扰相应升高,最长发声时间和嗓音障碍严重程度指数相应降低,差异有统计学意义,而平均基频差异无统计学意义(P>0.05)。喉肌电图募集相转折数与基频微扰、振幅微扰显著负相关(r=-0.472和r=-0.492,P＜0.05),与最长发声时间和嗓音障碍严重程度指数显著正相关(r=0.475和r=0.449,P＜0.05)。不同喉内肌的募集相转折数对嗓音声学参数的相关性存在一定特异性,环甲肌与基频微扰相关性最强(r=-0.472),而甲杓肌和环杓后肌与最大发音时间的相关性较高(r=0.452和r=0.417)。结论 喉肌电图募集相转折数能够客观反映声带麻痹患者的嗓音功能损伤程度,与嗓音声学分析参数具有相关性。将喉肌电图参数与声学分析结合,可为声带麻痹的全面评估和精准诊断提供新的客观依据,为个体化治疗方案的制定提供科学依据。

Abstract:

【Abstract】 Objective To investigate the correlation between laryngeal electromyography (LEMG) recruitment turn number and acoustic voice evaluation parameters, and to assess the application value of LEMG recruitment turn number in the vocal function evaluation of patients with vocal fold paralysis (VFP). This study aims to comprehensively evaluate the vocal status of VFP patients and guide treatment decisions. Methods A retrospective analysis was conducted on 51 patients diagnosed with unilateral VFP in the Department of Otorhinolaryngology, Head and Neck Surgery, at the First Hospital of Shanxi Medical University from October 2023 to December 2024. Based on LEMG results, patients were divided into two groups: superior laryngeal nerve dysfunction and recurrent laryngeal nerve dysfunction. All patients underwent acoustic voice analysis (including fundamental frequency [F0], jitter, shimmer, maximum phonation time [MPT], and dysphonia severity index [DSI]) and LEMG examinations to measure the recruitment turn numbers of laryngeal muscles on both the affected and unaffected sides.