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目的探讨老年喉形态学改变与嗓音变化之间的关系。方法对54例60岁以上健康老年人(男性29例,女性25例)的喉形态改变与嗓音声学特征进行了观察分析。健康青年对照组为21～22岁在校大学生46例,男女各23例。结果老年男性声带萎缩16例(55.2%),声门闭合不良18例(62.1%),声门下黏膜水肿16例(55.2%),室带超越(指发音时室带遮盖声带的部分或全部)12例(41.4%)。老年女性杓间区水肿15例(60.0%),声门闭合不良14例(56.0%),声带萎缩12例(48.0%),声带水肿8例(32.0%)。老年嗓音男性基频升高、女性基频下降,频率微扰、振幅微扰及噪谐比增大,嗓音的颤抖强度指数增加,特别是老年男性嗓音具有软发声特征。除老年女性频率微扰、振幅微扰及软发声指数升高无统计学意义外,其他参数与健康青年对照组比较,两者之间的差异均有统计学意义(P 值均小于0.05或0.01)。结论老年人在喉形态和嗓音声学特征上均出现了明显变化,除声带萎缩、声带水肿外,声门下黏膜水肿与杓间区水肿的发生率也很高。
Objective To explore the relationship between changes of laryngeal morphology and voice changes in elderly patients. Methods Fifty-four healthy elderly people over the age of 60 (29 males and 25 females) were observed and analyzed for laryngeal morphology and voice acoustics. Healthy youth control group of 21 to 22-year-old college students in 46 cases, 23 cases of both men and women. Results There were 16 cases of vocal cord atrophy (55.2%), 18 cases of glottis malocclusion (62.1%), 16 cases of subglottic mucosal edema (55.2%), 12 cases (41.4%). There were 15 cases (60.0%) of esophageal edema, 14 cases (56.0%) of glottic closure, 12 cases of vocal cord atrophy (48.0%) and 8 cases of vocal cord edema (32.0%). Elderly voice men increased the fundamental frequency, decreased female frequency, frequency perturbation, amplitude perturbation and noise ratio increased, voice twitch intensity index increased, especially in older men with voice characteristics of soft voice. Except elderly female with frequency perturbation, amplitude perturbation and soft voice index increased without statistical significance, the other parameters compared with healthy youth control group, the difference between the two were statistically significant (P values were less than 0.05 or 0.01 ). Conclusions There are obvious changes in laryngeal morphology and voice acoustics in the elderly. In addition to vocal cord atrophy and vocal cord edema, the incidence of subglottic mucosal edema and intertuberal area edema is also high.