声带下方收敛角度在声门闭合不全发声困难中可能的作用机理

发布时间：2018-06-06 05:06

本文选题：声带 + 斜截面　；参考：《听力学及言语疾病杂志》2017年04期

【摘要】：目的探讨喉三维CT重建下声带下方收敛角度的测量方法,探索声门闭合不全对声带下方收敛角度的影响,分析声门闭合不全发声疲劳可能的气流动力学原因。方法采用双源薄层CT,嘱受试者发/i:/音时扫描10例正常人的20侧声带(声门闭合组),深吸气时扫描8例单侧声带麻痹患者的麻痹侧声带(声门闭合不全组),经深吸气时扫描另10例正常人的20侧声带(声带外展组);导入影像数据于Mimics软件,构建声带及气道的3D模型,联合这两模型测量声带下方收敛角度;采用单因素方差分析,比较3组受试者声带下方收敛角度的差异;并尝试采用材料的斜截面应力分配原理进行声门下压力分析,探讨声门下收敛角度对启动发声时声带振动可能的影响。结果声门闭合组、声门闭合不全组及声带外展组的声带下方收敛角度分别为33.49°±3.75°、55.03°±2.61°及75.02°±7.32°,三组间差异有统计学意义(P0.01),声带下方收敛角度随声门闭合不全程度增加而增加。结论声带下方收敛角度可以通过声带及气道的3D模型进行有效测量,声门闭合不全程度增加会引起该角度增大,可能会导致声门下压力作用于声带下方的剪切力和正应力的分力发生变化,从而引起发声困难。
[Abstract]:Objective to investigate the measurement method of the convergence angle of the lower vocal cord under laryngeal 3D CT reconstruction, to explore the effect of glottic insufficiency on the convergence angle of the lower vocal cord, and to analyze the possible airflow dynamics causes of glottic incompletely vocal fatigue. Methods Twenty sides of vocal cords (glottic closure group) were scanned in 10 normal subjects (glottic closure group) and 8 patients with unilateral vocal cord paralysis (glottic insufficiency group) were scanned during deep inspiratory. Twenty sides of vocal cords (vocal cord outreaching group) were scanned in 10 other normal subjects. Image data were imported into Mimics software. A 3D model of vocal cord and airway was constructed and combined with these two models to measure the angle of convergence under the vocal cord, and the differences of the angle of convergence under the vocal cord in three groups were compared by single factor analysis of variance (ANOVA). The stress distribution principle of oblique cross section is used to analyze the pressure under the glottis, and the possible effect of the convergence angle of the subglottic on the vocal cord vibration is discussed. Results the lower convergence angles of glottic closure group, glottic insufficiency group and vocal cord outreaching group were 33.49 掳卤3.75 掳+ 55.03 掳卤2.61 掳and 75.02 掳卤7.32 掳, respectively. Conclusion the convergent angle under the vocal cord can be effectively measured by 3D model of the vocal cord and airway, and the increase of glottic incompleteness will cause the increase of the angle. It may lead to the change of shear force and normal stress acting on the lower part of the vocal cord, which may lead to difficulty in making sound.
【作者单位】：厦门大学附属中山医院耳鼻咽喉科;厦门大学附属中山医院放射科;
【基金】：国家自然科学基金(NSFC81371080) 福建省卫生系统中青年骨干人才培养项目(2013-ZQN-JC-35)资助
【分类号】：R767.4;R816.96

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