Applied Research Of Noninvasive Aerodynamics In Voice Function Evaluation

Objective To investigate the aerodynamic characteristics and differences of normaladults with different sexes and ages, and to adopt suitable aerodynamic parametersvalues.Methods The Phonatory Aerodynamic System (PAS) was used to collect phonationthreshold pressure(PTP), phonation threshold flow(PTF), subglottal pressure(SGP),mean flow rate(MFR), maximum phonation time(MPT), glottal resistance(GR) andvocal efficiency(VE) from adults with normal voice. The100normal adults weredivided by sex (male and female) and age (Less than30,31to45, more than46).Multivariate statistical analysis was used to assess.Results The PTF, MFR, MPT of male were significantly higher then female,whereas the GR of male were significantly lower than female. The diffenences of PTP,SGP and VE in sexes were not significant. All the aerodynamic parameters were notsignificantly different in various ages. The reference values of PTP, PTF, SGP, MFRand MPT were small, yet the GR and VE were large.Conclusion The flow related parameters were significantly affected by gender innormal voices, and the pressure related parameters were not. The GR of female washigher than male, but the VE was not. Aerodynamic parameters were not significantdifferences in various ages. The individual variability of PTP, PTF, SGP, MFR andMPT was small, and they were adequate for clinical assessment. The GR and VE hada large individual range, and the clinical evaluation values were small. Objective To investigate the variation of aerodynamic parameters in voice diseasesby aerodynamic examination; To find the sensitive index and threshold value.Methods The Phonatory Aerodynamic System(PAS) was used to collect phonationthreshold pressure(PTP), phonation threshold flow(PTF), subglottal pressure(SGP),mean flow rate(MFR), maximum phonation time(MPT), glottal resistance (GR) andvocal efficiency(VE) from72patients with vocal fold polys,22patients with vocalfold cysts,19patients with vocal fold limitation and100normal voices. Statisticsmethods of rank sum test, receiver operating characteristics(ROC) analysis andlogistic regression analysis were used to analysis.Results The PTP, PTF, SGP, MFR and MPT were significantly difference betweenthree kinds of voice diseases and normal voice (P<0.05or P<0.01), yet the differenceof GR and VE were significant (P>0.05). ROC analysis showed that the area underthe curve of PTP, PTF, SGP, MFR and MPT were0.910,0.853,0.893,0.864and0.862, and all of them had diagnostic value, especially PTP. When threshold value ofPTP, PTF, SGP and MFR were5.12cm H2O,6.80cm H2O,0.12Lit/Sec and0.22Lit/Sec from logistic regression analysis, the probability of illness was high (85%,83%,77%and77%).Conclusion The variation PTP, PTF, SGP, MFR and MPT were significant, and hadgood auxiliary diagnosis value, especially PTP. The GR and VE had a large individualrange, and the clinical evaluation value was small. When PTP was greater than5.12cm H2O, SGP was greater than6.80cm H2O, PTF was greater than0.12Lit/Sec,MFR was greater than0.22Lit/Sec, the probability of illness was85%,83%,77%and77%respectively. The threshold value for auxiliary diagnosis was high sensitivity andspecificity. The aerodynamic measure can make objective assessment in Laryngealfunction of voice diseases，which can be a routine in examination for voice disorders. Objective To investigate the Laryngeal function of vocal fold polyps pre and postmicrophonasurgery by noninvasive aerodynamic assessment.Methods Aerodynamic analysis about41patients diagnosed with vocal polyps (oneday before surgery and six weeks after surgery), including mean phonation flow rate,maximum phonation time, subglottal pressure, glottal resistance, glottal efficiency,phonation threshold pressure and phonation threshold flow were recorded byphonatory aerodynamic system(PAS). The VHI-10and acoustic parameters such asfundamental frequency, jitter percent, shimmer percent and NHR are included. Thecorrelations between them are compared.Results The value of mean flow rate, maximum phonation time, subglottal pressure,phonation threshold pressure and phonation threshold flow had significant differencepre and post surgery(P<0.01). Conversely, the value of glottal resistance and glottalefficiency had varied widely and had no significant difference(P>0.05). Thedifference was significant in VHI-10, jitter percent, shimmer percent and NHR postsurgery(P<0.01).The correlations of difference value between aerodynamicparameters, acoustic parameters and VHI-10were not significant difference.Conclusion The mean flow rate, maximum phonation time, subglottal pressure,phonation threshold pressure and phonation threshold flow was good to assess thechanges of laryngeal function pre and post surgery. The clinical value of glottalresistance and glottal efficiency was little. The same as VHI-10and acousticevaluation, the aerodynamic measure can make objective assessment in Laryngealfunction of vocal fold polyps pre and post surgery therapy, which can be a usefulmethod in evaluating the therapy effiency after phonomicrosurgery.