扁桃体腺样体切除术对患儿嗓音特征及共鸣参数的影响

doi:10.6040/j.issn.1673-3770.0.2025.050

摘要/Abstract

摘要： 目的探讨扁桃体腺样体切除术对患儿嗓音特征及共鸣参数的影响。方法选取行扁桃体腺样体肥大切除术的61例患儿为实验组,同期在本院健康体检儿童61例为健康对照组。所有儿童均行多维嗓音学检查,比较两组及患儿手术前后多维嗓音学参数:基频(fundamental frequency, F0)、基频微扰(Jitter)、振幅微扰(Shimmer)、振幅变化系数(amplitude variation coefficient, vAm)、噪谐比(noise harmonic ratio, NHR)、嗓音紊乱指数(voice turmoil index, VTI)、软发音指数(soft production index, SPI)、共振峰频率(formant frequencies, F1~F3)及带宽(bandwidths, B1~B3)。结果术前,实验组vAm高于健康对照组(P<0.001),实验组F0、Jitter、Shimmer、NHR、VTI、SPI与对照组比较差异无统计学意义(P>0.05)。与术前1 d比较,术后15 d患儿vAm降低,术后30 d的vAm、NHR降低(P均<0.001),术后30 d患儿共振峰频率值及带宽降低,差异有统计学意义(均P<0.001)。结论腺样体及扁桃体切除术能够降低患儿vAm、NHR、共振峰频率值及带宽。

关键词: 多维嗓音学检查, 扁桃体腺样体肥大, 嗓音特征, 共鸣参数, 扁桃体腺样体切除术

Abstract: Objective To explore the effects of tonsillectomy and adenoidectomy on vocal characteristics and resonance parameters in children. Methods A total of 61 children undergoing tonsillectomy and adenoidectomy, and 61 healthy children who underwent physical examination in the hospital were enrolled as experimental group and healthy control group, respectively. The multi-dimensional vocal examination was performed for all children to compare multi-dimensional vocal parameters ［fundamental frequency(F0), Jitter, Shimmer, amplitude variation coefficient(vAm), noise harmonic ratio(NHR), voice turmoil index(VTI), soft production index(SPI), formant frequencies(F1-F3), bandwidths(B1-B3)］ between the two groups before and after surgery. Results Before surgery, vAm in experimental group was higher than that in healthy control group(P<0.001), but there was no significant difference in F0, Jitter, Shimmer, NHR, VTI or SPI between the two groups(P>0.05). Compared with 1d before surgery, vAm was decreased at 15d after surgery, vAm and NHR were decreased at 30d after surgery(all P<0.001), formant frequencies and bandwidths were decreased at 30d after surgery(all P<0.001). Conclusion Adenoidectomy and tonsillectomy can reduce vAm, NHR, formant frequencies and bandwidths in children.

Key words: Multi-dimensional vocal examination, Tonsillar and adenoid hypertrophy, Voice characteristic, Resonance parameter, Adenoidectomy and tonsillectomy

中图分类号:

R766.5

陈巧婷,邹嵩,朱金枝,张金星,李健祥. 扁桃体腺样体切除术对患儿嗓音特征及共鸣参数的影响[J]. 山东大学耳鼻喉眼学报, 2026, 40(5): 53-56.

CHEN Qiaoting, ZOU Song, ZHU Jinzhi, ZHANG Jinxing, LI Jianxiang. Effects of tonsillectomy and adenoidectomy on vocal characteristics and resonance parameters in children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(5): 53-56.

参考文献

[1] 万玉峰, 刘龙生, 徐盼盼, 等. 腺样体肥大或伴扁桃体肥大的睡眠呼吸障碍儿童平均血小板体积和血小板分布宽度变化的临床意义[J]. 安徽医学, 2020, 41(4): 379-382. DOI:10.3969/j.issn.1000-0399.2020.04.005
[2] 史欣, 蒋源, 孙继周, 等. 等离子射频消融术对小儿扁桃体腺样体肥大的疗效[J]. 河北医药, 2023, 45(10): 1540-1542,1546. DOI:10.3969/j.issn.1002-7386.2023.10.024.
[3] 高淑蔚, 郭永丽, 许志飞. 阻塞性睡眠呼吸暂停综合征儿童腺样体扁桃体切除术后治疗效果及其预测因素的研究进展[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(6): 630-634. DOI: 10.3760/cma.j.cn115330-20191105-00666
[4] 张静, 魏玮, 黄振云, 等. 升麻解毒方结合白三烯受体拮抗剂对肺经蕴热证儿童腺样体肥大的疗效及其对A/N比率的影响[J]. 川北医学院学报, 2021, 36(8): 1019-1023. DOI:10.3969/j.issn.1005-3697.2021.08.017
[5] Nicodemo J, Hamersley E, Baker P, et al. Benign adenoidal hypertrophy caused by adenovirus presenting as a nasopharyngeal mass concerning for malignancy[J]. Int J Pediatr Otorhinolaryngol, 2020, 138: 110300. DOI: 10.1016/j.ijporl.2020.110300
[6] 马志强, 宋惠芸, 于海玲. 扁桃体、腺样体切除术对语音及嗓音影响研究进展[J]. 山东大学耳鼻喉眼学报,2023,37(1):120-123,131. DOI: 10.6040/j.issn.1673-3770.0.2021.559
[7] 曹媛, 张奇雪, 阮宏莹, 等. 声带占位病变患者多维嗓音声学分析及发声空气动力学检测比较[J]. 听力学及言语疾病杂志, 2019, 27(3):280-284. DOI:10.3969/j.issn.1006-7299.2019.03.011
[8] 孙虹, 张罗. 耳鼻咽喉头颈外科学[M]. 9版. 北京: 人民卫生出版社, 2018: 215-216
[9] 吴长珍, 卢爱华, 孙霞, 等. 基于鼻咽X线摄影侧位片及鼻内镜诊断的腺样体肥大致学龄期儿童OSAHS与情绪障碍的关系[J]. 医学影像学杂志, 2024, 34(8): 26-29
[10] 王淇, 陈银忠. 睡眠呼吸障碍伴腺样体和/或扁桃体肥大患儿血常规指标变化的临床分析[J]. 中国耳鼻咽喉颅底外科杂志, 2026, 32(1): 78-85. DOI:10.11798/j.issn.1007-1520.202625109
[11] 郝中平, 顾怀宇, 李雯, 等. 鼻内镜下低温等离子切除术对扁桃体及腺样体肥大患儿创伤应激、 CC类趋化因子的影响[J]. 实用临床医药杂志, 2022, 26(5): 127-130,143. DOI:10.7619/jcmp.20212626
[12] 米晓琳, 曹志伟, 王萌, 等. 儿童扁桃体腺样体肥大与哮喘的关系及扁桃体腺样体切除术后哮喘变化分析[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(8):760-764. DOI:10.13201/j.issn.2096-7993.2021.08.019
[13] 舒艳梅, 彭春梅, 黄艳, 等. 失效模式与效应分析护理模式在鼻窦炎合并腺样体肥大患者手术室安全管理中的应用[J]. 实用医院临床杂志, 2022, 19(1):147-150. DOI:10.3969/j.issn.1672-6170.2022.01.039
[14] 杨佳讯, 王志琴, 吴劲燕. 护理临床路径在低温等离子射频消融术治疗儿童扁桃体和腺样体肥大中的应用[J]. 中华危重症医学杂志(电子版), 2020, 13(4): 319-320. DOI:10.3877/cma.j.issn.1674-6880.2020.04.018
[15] 刘益建, 王军民, 孙浩, 等. 加减疏风清热汤在扁桃体伴腺样体肥大切除术中的应用[J]. 辽宁中医杂志, 2024, 51(11):103-106. DOI:10.13192/j.issn.1000-1719.2024.11.027
[16] 武雅琴, 张佳庆, 张涛. 数据增强和复杂特征优化的类不平衡病理嗓音检测[J]. 应用声学, 2025, 44(1): 234-244. DOI:10.11684/j.issn.1000-310X.2025.01.025
[17] Tse KL, Savoldi F, Li KY, et al. Prevalence of adenoid hypertrophy among 12-year-old children and its association with craniofacial characteristics: a cross-sectional study[J]. Prog Orthod, 2023, 24(1): 31. DOI: 10.1186/s40510-023-00481-4
[18] 马志强, 宋惠芸,于海玲. 儿童扁桃体腺样体肥大对嗓音影响分析[J]. 中国耳鼻咽喉头颈外科, 2023, 30(1): 36-39. DOI:10.16066/j.1672-7002.2023.01.009
[19] Abdel-Aziz M, El-Fouly M, Nassar A, et al. The effect of hypertrophied tonsils on the velopharyngeal function in children with normal palate[J]. Int J Pediatr Otorhinolaryngol, 2019, 119: 59-62. DOI: 10.1016/j.ijporl.2019.01.017
[20] 谢冰, 李哲, 王红星, 等. 探析元音与声强对嗓音声学共振峰检测结果的影响[J]. 临床耳鼻咽喉头颈外科杂志, 2024, 38(12):1149-1153. DOI: 10.13201/j.issn.2096-7993.2024.12.011
[21] Sundberg J, Lindblom B, Hefele AM. Voice source, formant frequencies and vocal tract shape in overtone singing. A case study[J]. Logoped Phoniatr Vocol, 2023, 48(2): 75-87. DOI: 10.1080/14015439.2021.1998607
[22] Gomaa MA, Mohammed HM, Abdalla AA, et al. Effect of adenoid hypertrophy on the voice and laryngeal mucosa in children[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(12): 1936-1939. DOI: 10.1016/j.ijporl.2013.08.039
[23] Mora R, Crippa B, Dellepiane M, et al. Effects of adenotonsillectomy on speech spectrum in children[J]. Int J Pediatr Otorhinolaryngol, 2007, 71(8): 1299-1304. DOI: 10.1016/j.ijporl.2007.05.005
[24] 杨菁菁, 程丽宇, 徐文. 儿童腺样体及扁桃体切除术后发音特征变化的研究[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(7):724-729. DOI:10.3760/cma.j.cn115330-20200813-00672

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