The Study Of Aerodynamic Of Voice Disease In Different Phonation Condition

Objective To study the characteristic changes of the subglottal pressure (SGP), mean airflow rate (MFR), glottal resistance (GR), vocal efficiency (VE) in some common voice disease under comfortable speech condition and loud speech condition. By comparing the aerodynamic differences among the diseases, to discuss the effect of the vocal fold diseases on the airflow pass through the glottic, and the importance of the aerodynamic exam in diagnosis and evaluation of voice diseases.Method133subjects were entered this study. All the subjects were excluded respiratory disease, neurological disorder, auditory disorder. According to the history, physical sign and electrolaryngoscopic exam, all the subjects were subdivided into the control group (male25, female27), vocal nodules group (female12), vocal polyp group (male13, femal17), vocal fold leukoplakia group (male12), vocal fold scar group (female8), bilateral ventricular fold phonation group after type III cordectomy (male9), unilateral ventricular fold phonation group after type III cordectomy (male10). Examed the aerodynamic parameters by means of the Phonatory Aerodynamic System6600(PAS6600), compared the differences of the SGP, MFR, GR, VE in comfortable speech and loud speech, found the special aerodynamic parameters of voice disorders by ROC cure and logistic analysis.Results SP:The number of the female was higher than the male in vocal polyp (VP) group (P=0.005).The number were increased in VP group (Male), vocal fold leukoplakia (VFL) group, bilateral ventricular fold phonation (BVP) group, vocal fold scar (VFS) group (P=0.001, P=0.005, P=0.000, P=0.000). MFR: The number of the male were higher than the female in NG and VP group (P=0.000, P=0.005). The number in VFL group, BVP group, vocal nodules (VN) group, VP group (female), VFS group were increased (P=0.000, P=0.000, P=0.003, P=0.001, P=0.008), decreased in unilateral ventricular fold phonation (UVP) group (P=0.000). GR:The number were lower in the male than the female (P=0.000, P=0.001). The number were increased in UVP group (P=0.000), decreased in BVP group, VN group, VP group (female), VFS group (P=0.000, P=0.000, P=0.011, P=0.002). VE:The number were decreased in BVP group, VN group, VP group (female), VFS group (P=0.025, P=0.001, P=0.016, P=0.003). Subglottic pressure alteration rate (SGPAR):The number were increased in UVP group (P=0.000). The number were decreased in VP group (female), VFS group (P=0.001, P=0.005). Mean airflow rate alteration rate (MFRAR):The number of the male was higher than the female in NG and VP group (P=0.005, P=0.035). The number was increased in UVP group (P=0.008), decreased in VFL group (P=0.000). Glottal efficiency alteration rate (GEAR):The number of the female was higher than the male in NG group (P=0.005), lower in VP group (P=0.023). The number were increased in VP group (male), decreased in BVP group (P=0.027), UVP group, VP group (female), VFS group (P=0.001, P=0.001, P=0.000, P=0.000). Voice efficiency alteration rate (VEAR):The number of the female was higher than the male in NG and VP group (P=0.000, P=0.000). The number were decreased in VFL group and VFS group (P=0.001, P=0.002), increased in female VP group (P=0.000).VP (male):The area under the curve (AUC) in SGPAR was0.822, the number was0.55, the sensitivity and specificity were0.769and0.875, the prevalence rate (PR) was88.4%. VFL:The AUC in VEAR was0.864, the number was1.55, the sensitivity and specificity were0.917and0.842, the PR was75.4%. BVP:The AUC in MFR, GR, VE were1.000, when the number were0.78L/s,15.21cmH2O/(L/s),24.88ppm, the sensitivity and specificity were1.000and1.000, the PR was100%. UVP:The AUC in GR was0.976, when the number was42.16cmH2O/(L/s), the sensitivity and specificity were1.000and0.932, the PR was95.7%. VN:The AUC in GR was0.776, when the number was43.09cmH2O/(L/s), the sensitivity and specificity were0.917and0.767, the PR was81.3%. VP (female):The AUC in VEAR was0.810, when the number was10.94, the sensitivity and specificity were0.765and0.830, the PR was81.3%. VFS:The AUC in VEAR was1.000, when the number was1.75, the sensitivity and specificity were1.000and1.000, the PR was100%.Conclusions There are gender differences of MFR and GR in NG, and they are related to the different anatomy and physiology of the vocal fold and larynx between male and female. This maybe the reason that why the female are more vulnerable to voice disorder. The VE is increased remarkably in loud speech, and higher VE with higher rick of phonaltrauma, so it will be more likely to lead to the voice disease in loud speech. There are remarkable changes of the aerodynamic parameters in voice diseases, with the decreases of adjustment ability in loud speech. The phenomenons are probably related to the changes of the glottal area, vocal fold mass, vocal fold viscosity, stiffness and elasticity. There are characteristic parameter changes in all the voice diseases in this study, so the aerodynamic exam is valuable for the diagnosis and evaluation of voice disorders.