山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (3): 14-18.doi: 10.6040/j.issn.1673-3770.1.2019.022

• 专家笔谈 • 上一篇    下一篇

老年期嗓音的生理特征及保健

徐洁洁()   

  1. 南京医科大学第一附属医院 江苏省人民医院耳鼻咽喉科,江苏 南京210029
  • 收稿日期:2019-04-16 修回日期:2019-05-13 出版日期:2019-05-20 发布日期:2019-08-07
  • 通讯作者: 徐洁洁 E-mail:xujiejie2@hotmail.com
  • 作者简介:徐洁洁,医学博士, 教授, 主任医师。主要学术任职:中华医学会耳鼻咽喉头颈外科学分会嗓音学组委员,中国中西医结合学会耳鼻咽喉科专业委员会委员、嗓音专家委员会常务委员,中国艺术医学协会嗓音专业委员会常务委员。 《听力学及言语疾病杂志》《南京医科大学学报》等期刊编委,《中华耳鼻咽喉头颈外科杂志》审稿专家。

Physiological characteristics of voice and care of vocal health in the elderly

Jiejie XU()   

  1. Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu, China
  • Received:2019-04-16 Revised:2019-05-13 Online:2019-05-20 Published:2019-08-07
  • Contact: Jiejie XU E-mail:xujiejie2@hotmail.com

摘要:

老年期全身各器官系统发生退行性变化,可影响发声器官的组织结构及生理功能,引起嗓音衰老。该文概述了老年人喉部组织结构、声门外观形态及嗓音生理特征的改变,并阐明老年期嗓音保健的相关措施,有助于区别老年期喉生理性与病理性改变,进行适当合理的老年嗓音功能保护,从而提高老年人群的生活质量。

关键词: 老年人, 声学, 嗓音质量, 嗓音保健

Abstract:

Degenerative age-related changes in the body organs can affect the structure and physiological function of the vocal cords and cause senescence of voice in the elderly. This paper summarizes the changes in laryngeal structure, glottis appearance, and physiological vocal characteristics of aged subjects, and states the steps that need to be taken to care for vocal health of patients at an advanced age. This will be helpful to distinguish between the physiological and pathological changes of the larynx in the elderly and carry out appropriate and reasonable voice protection measures, thereby improving the quality of life in the aged population.Degenerative age-related changes in the body organs can affect the structure and physiological function of the vocal cords and cause senescence of voice in the elderly. This paper summarizes the changes in laryngeal structure, glottis appearance, and physiological vocal characteristics of aged subjects, and states the steps that need to be taken to care for vocal health of patients at an advanced age. This will be helpful to distinguish between the physiological and pathological changes of the larynx in the elderly and carry out appropriate and reasonable voice protection measures, thereby improving the quality of life in the aged population.

Key words: Aged, Acoustics, Voice quality, Voice health

中图分类号: 

  • R767.92
1 王荣光, 王刚. 老年性嗓音障碍[J]. 老年医学与保健, 2010,16(5): 261-263.doi:10.3969/j.issn.1008-8296.2010-05-03.
doi: 10.3969/j.issn.1008-8296.2010-05-03
2 ThomasLB, HarrisonAL, StempleJC. Aging thyroarytenoid and limb skeletal muscle: lessons in contrast[J]. J Voice, 2008, 22(4): 430-450. doi:10.1016/j.jvoice.2006. 11.006.
doi: 10.1016/j.jvoice.2006. 11.006
3 KandoğanT, OlgunL, GültekinG. Causes of dysphonia in patients above 60 years of age[J]. Kulak Burun Bogaz Ihtis Derg, 2003, 11(5): 139-143.
4 CostaHO, MatiasC. Vocal impact on quality of life of elderly female subjects[J]. Braz J Otorhinolaryngol, 2005, 71(2): 172-178. doi:/S0034-72992005000200010.
doi: /S0034-72992005000200010
5 Verdonck-de LeeuwIM, MahieuHF. Vocal aging and the impact on daily life: a longitudinal study[J]. J Voice, 2004, 18(2): 193-202. doi:10.1016/j.jvoice.2003.10.002.
doi: 10.1016/j.jvoice.2003.10.002
6 Kosztyla-HojnaB, AndrzejewskaA, RutkowskiR, et al. Morphological aspect of voice disturbances of aged persons coexisting hypopharynx cancer[J]. Folia Histochem Cytobiol, 2007, 45(3): 221-227.
7 SatoK, HiranoM, NakashimaT. Age-related changes of collagenous fibers in the human vocal fold mucosa[J]. Ann Otol Rhinol Laryngol, 2002, 111(1): 15-20. doi:10.1177/000348940211100103.
doi: 10.1177/000348940211100103
8 AbdelkafyWM, SmithJQ, HenriquezOA, et al. Age-related changes in the murine larynx: initial validation of a mouse model[J]. Ann Otol Rhinol Laryngol, 2007, 116(8): 618-622. doi:10.1177/000348940711600810.
doi: 10.1177/000348940711600810
9 李翠娥, 陶泽璋, 周涛, 等. D-半乳糖致衰老豚鼠声带老化特征研究[J]. 听力学及言语疾病杂志, 2013, 21(2): 159-162. doi:10.3969/j.issn.1006-7299.2013.02.019.
doi: 10.3969/j.issn.1006-7299.2013.02.019
LICui′e, TAOZezhang, ZHOUTao, et al. The characteristics of the D-galactose induced aging guinea pig used for presbyphonia[J]. Journal of Audiology and Speech Pathology, 2013, 21(2): 159-162. doi:10.3969/j.issn.1006-7299.2013.02.019.
doi: 10.3969/j.issn.1006-7299.2013.02.019
10 李翠娥, 周涛, 陶泽璋, 等. 老年豚鼠喉部细胞外基质成分的改变和意义[J]. 中华老年医学杂志, 2014, 33(7): 807-809. doi:10.3760/cma.j.issn.0254-9026.2014.07.033.
doi: 10.3760/cma.j.issn.0254-9026.2014.07.033
LICui′e, ZHOUTao, TAOZezhang, et al. The changes and significance of the extracellular matrix in larynx of old guinea pig[J]. Chinese Journal of Geriatrics, 2014, 33(7): 807-809. doi:10.3760/cma.j.issn.0254-9026.2014.07.033.
doi: 10.3760/cma.j.issn.0254-9026.2014.07.033
11 McMullenCA, AndradeFH. Functional and morphological evidence of age-related denervation in rat laryngeal muscles[J]. J Gerontol A Biol Sci Med Sci, 2009, 64(4): 435-442. doi:10.1093/gerona/gln074.
doi: 10.1093/gerona/gln074
12 SuzukiT, ConnorNP, LeeK, et al. Age-related alterations in myosin heavy chain isoforms in rat intrinsic laryngeal muscles[J]. Ann Otol Rhinol Laryngol, 2002, 111(11): 962-967. doi:10.1177/000348940211101102.
doi: 10.1177/000348940211101102
13 ConnorNP, SuzukiT, LeeK, et al. Neuromuscular junction changes in aged rat thyroarytenoid muscle[J]. Ann Otol Rhinol Laryngol, 2002, 111(7 Pt1): 579-586. doi:10.1177/000348940211100703.
doi: 10.1177/000348940211100703
14 韩德民, SataloffRT, 徐文. 嗓音医学[M].2版.北京:人民卫生出版社, 2017:60-62.
15 江德胜,余养居. 嗓音外科学[M].上海:上海世界图文出版公司,2004:9-11.
16 胡环宇, 徐洁洁, 陈曦, 等. 老年人喉镜观察及嗓音声学和空气动力学分析[J]. 江苏医药, 2013, 39(14): 1636-1638.
HUHuanyu, XUJiejie, CHENXi, et al. Laryngoscopy and voice acoustic and aerodynamic analysis in the elderly[J]. Jiangsu Medical Journal, 2013, 39(14): 1636-1638.
17 陶泽璋, 周涛. 重视老年嗓音的防治[J]. 老年医学与保健, 2010, 16(5): 274-275. doi:10.3969/j.issn.1008-8296.2010-05-08.
doi: 10.3969/j.issn.1008-8296.2010-05-08
TAOZezhang, ZHOUTao. Prevention and treatment of presbyphonia[J]. Geriatrics & Health Care, 2010, 16(5): 274-275. doi:10.3969/j.issn.1008-8296.2010-05-08.
doi: 10.3969/j.issn.1008-8296.2010-05-08
18 梁莺, 黄魏宁, 张程, 等. 正常老年人嗓音变化的观察与分析[J]. 临床耳鼻咽喉科杂志, 2000, 14(11): 512-514. doi:10.3969/j.issn.1001-1781.2000.11.013.
doi: 10.3969/j.issn.1001-1781.2000.11.013
LIANGYing, HUANGWeining, ZHANGCheng, et al. Observation and analyses on voice changes in the normal aged[J]. Journal of Clinical Otorhinolaryngology, 2000, 14(11): 512-514. doi:10.3969/j.issn.1001-1781.2000.11.013.
doi: 10.3969/j.issn.1001-1781.2000.11.013
19 王丽萍, 高远, 杨静, 等. 老年喉形态学改变与嗓音变化之间的关系[J]. 中华耳鼻咽喉头颈外科杂志, 2006, 41(9): 657-660. doi:10.3760/j.issn:1673-0860.2006.09.005.
doi: 10.3760/j.issn:1673-0860.2006.09.005
WANGLiping, GAOYuan, YANGJing, et al. Relationship between laryngeal morphology and voice changes in old people[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2006, 41(9): 657-660. doi:10.3760/j.issn:1673-0860.2006.09.005.
doi: 10.3760/j.issn:1673-0860.2006.09.005
20 郑阳阳, 徐洁洁, 陆美萍, 等. 成年女性不同生理年龄期嗓音功能主观评估及声学分析[J]. 江苏医药, 2017, 43(1): 32-35. doi:10.19460/j.cnki.0253-3685.2017.01.011.
doi: 10.19460/j.cnki.0253-3685.2017.01.011
ZHENGYangyang, XUJiejie, LUMeiping, et al. Voice subjective assessment and acoustic analysis of normal adult female in different physiological periods[J]. Jiangsu Medical Journal, 2017, 43(1): 32-35. doi:10.19460/j.cnki.0253-3685.2017.01.011.
doi: 10.19460/j.cnki.0253-3685.2017.01.011
21 FerrandCT. Harmonics-to-noise ratio: an index of vocal aging[J]. J Voice, 2002, 16(4): 480-487.
22 万萍, 黄昭鸣. 年龄和性别因素对老年嗓音的影响[J]. 临床耳鼻咽喉头颈外科杂志, 2007, 21(20): 929-931. doi:10.3969/j.issn.1001-1781.2007.20.006.
doi: 10.3969/j.issn.1001-1781.2007.20.006
WANPing, HUANGZhaoming. Effect of age and gender to voice quality[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2007, 21(20): 929-931. doi:10.3969/j.issn.1001-1781.2007.20.006.
doi: 10.3969/j.issn.1001-1781.2007.20.006
23 LinvilleSE, RensJ. Vocal tract resonance analysis of aging voice using long-term average spectra[J]. J Voice, 2001,15(3):323-330.doi:10.1016/S0892-1997(01)000-34-0.
doi: 10.1016/S0892-1997(01)000-34-0
24 TakanoS, KimuraM, NitoT, et al. Clinical analysis of presbylarynx: vocal fold atrophy in elderly individuals[J]. Auris Nasus Larynx, 2010, 37(4): 461-464. doi:10.1016/j.anl.2009.11.013.
doi: 10.1016/j.anl.2009.11.013
25 侯丽珍,韩德民. 嗓音年龄变化特点及其解剖生理机制的探讨[J]. 国外医学耳鼻咽喉科学分册,2001, 25(5):287-291.doi:10.3760/cma.j.issn.1673-4106.2001.05.008.
doi: 10.3760/cma.j.issn.1673-4106.2001.05.008
26 TomitaH, NakashimaT, MaedaA, et al. Age related changes in the distribution of laryngeal glands in the human adult larynx[J]. Auris Nasus Larynx, 2006, 33(3): 289-294. doi:10.1016/j.anl.2006.01.001.
doi: 10.1016/j.anl.2006.01.001
27 BergEE, HapnerE, KleinA, et al. Voice therapy improves quality of life in age-related dysphonia: a case-control study[J]. J Voice, 2008, 22(1): 70-74. doi:10. 1016/j.jvoice.2006.09.002.
doi: 10. 1016/j.jvoice.2006.09.002
28 张念祖, 夏立军, 陈彦球, 等. 中老年合唱团的嗓音调查与分析[J]. 听力学及言语疾病杂志, 2005, 13(5): 314-316. doi:10.3969/j.issn.1006-7299.2005.05.005.
doi: 10.3969/j.issn.1006-7299.2005.05.005
ZHANGNianzu, XIALijun, CHENYanqiu, et al. Voice investigation and analysis of aged chorus[J]. Journal of Audiology and Speech Pathology, 2005, 13(5): 314-316. doi:10.3969/j.issn.1006-7299.2005.05.005.
doi: 10.3969/j.issn.1006-7299.2005.05.005
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