英国 icSpeech 鼻-口腔气流比率测量系统 SNORS

摘要 · 中文整理：本文介绍了一种以红外光为无创探测手段的仪器的研制，该仪器可检测言语过程中唇的开启、开启程度以及唇的前突与后缩运动。其设计准则是构建一种简单的独立式唇功能评估手段，同时能够与该研究组商品化的超级鼻腔-口腔比率测量系统（SNORS+）联接。SNORS+ 可对关键构音器官的功能与协调性进行客观评估，此前其唇功能是通过摄像机进行监测的。研究使用新的唇功能监测仪与摄像机同步进行测试，以验证所产生的信号与口部活动直接相关。随后开展了一项小规模试验，以表明该系统在一系列“正常”受试者中能够给出可重复的结果。这些受试者性别与种族不同，从而构成一个唇部尺寸与面部形状各异的样本群体。本文给出了仪器的技术细节与试验结果，结果提示该仪器简单的可视化输出与反馈将在言语障碍的评估与管理中发挥作用。

原文摘要：This paper describes the development of an instrument using infrared light as a non-invasive means of detecting lip opening, the extent of the opening and also the forward protrusion and backward movement of the lips during speech. The design criteria were to build a simple stand alone means of assessing lip function, which could also link to the group's commercially available Super Nasal-Oral Ratiometry System (SNORS+). SNORS+ allows objective assessment of the function and co-ordination of key articulators, with lip function previously monitored using a video camera. Synchronised tests were carried out using the new Lip Function Monitor and the video camera simultaneously, in order to verify that the signals produced related directly to the activity of the mouth. A small trial was then conducted to show that the system provides reproducible results throughout a range of 'normal' subjects. These subjects were of different gender and race to create a sample group within which there was a variety of lip sizes and face shapes. Technical aspects of the instrument and trial results are presented here. These suggest that the simple visual output and feedback of the instrument will prove useful in the assessment and management of speech disorders.

关键词：唇功能、红外、无创评估、SNORS+ 多参数言语工作站、构音器官、言语障碍

研究目标：解决 SNORS+ 多参数言语评估系统中唇功能只能依赖摄像机监测、缺乏简单无创电信号测量手段的问题。

主要结论：研制的红外唇功能监测仪信号与口部活动直接对应，在性别、种族各异的正常受试者中结果可重复；其简单的可视输出与反馈可与 SNORS+ 联用，有望用于言语障碍的评估和管理。

创新点：首次将红外光无创唇部运动检测集成到 SNORS+ 多参数言语评估平台，取代摄像机实现唇开合与前后运动的电信号量化。

后续建议：在言语障碍患者群体中验证仪器的临床区分能力；建立唇部运动参数的正常参考范围；与鼻口气流等通道联合建立构音协调性的定量指标；改进传感器布置以减少头部运动和环境光的干扰；评估其作为唇部构音生物反馈治疗工具的效果

APA 引文：Dawes, K. S., & Kelly, S. W. (2005). An instrument for the non-invasive assessment of lip function during speech. Medical Engineering & Physics, 27(6), 523–535. https://doi.org/10.1016/j.medengphy.2004.11.007

仪器引用：The design criteria were to build a simple stand alone means of assessing lip function, which could also link to the group's commercially available Super Nasal-Oral Ratiometry System (SNORS+). SNORS+ allows objective assessment of the function and co-ordination of key articulators, with lip function previously monitored using a video camera.

摘要 · 中文整理：超级鼻腔-口腔比率测量系统（SNORS）是一种商品化系统，可测量言语过程中的鼻腔气流与口腔气流，从而实现对软腭快速运动的测量。SNORS 使用一只改良的氧气面罩（其中安装了气流传感器与麦克风）以及一台标准个人计算机。通过计算鼻化度（鼻腔气流占气流的百分比），可获得不受言语强度影响的腭咽闭合估计。SNORS 可用于客观评估：受试者需朗读若干经挑选、能体现腭咽功能的词。SNORS 还通过鼻腔与口腔气流的简单实时显示提供生物反馈。腭咽闭合不全（VPI）指无法完成充分的腭咽闭合，可能源于神经性原因，或如本例源于结构性异常，会导致辅音省略、替代或弱化以及鼻音过重等异常言语特征。患者 T.W. 为 52 岁男性，因切除扁桃体癌接受了大范围颌面外科手术，术后言语鼻音极重。SNORS 被成功用作该患者治疗中的评估工具与治疗工具，研究比较了常规言语语言治疗与 SNORS 生物反馈治疗的效果。最初患者软腭虽有一定运动，但无法完成腭咽闭合；常规治疗旨在增强并改善软腭功能，治疗后仅有轻微改善：患者可以达成闭合但无法维持。经过一段非治疗期后复评，变化甚微。随后实施 SNORS 生物反馈治疗，提高了患者对自身腭咽功能的意识，帮助其维持闭合，从而减轻鼻音过重。在本例中，SNORS 治疗明显比常规言语语言治疗更有效。文中还概述了进一步的干预方案，并讨论了言语多参数评估的益处。

原文摘要：The super nasal oral ratiometry system (SNORS) is a commercially available system which measures both nasal and oral airflow during speech, allowing the very rapid movement of the velum to be measured. SNORS uses a modified oxygen mask, which houses the airflow sensors and microphones, and a standard personal computer. By calculating nasalance (the percentage of airflow that is nasal), an estimation of velopharyngeal closure, which is independent of speech intensity, is achieved. SNORS can be used for objective assessment, where the subject is required to speak a number of words selected to demonstrate velopharyngeal function. SNORS also provides biofeedback, using a simple realtime display of nasal and oral airflow. Velopharyngeal insufficiency (VPI) is the inability to make adequate velpharyngeal closure, and may be the result of either neurological or, as in this case, structural abnormalities. It results in abnormal speech characteristics, such as omissions, substitutions or weak articulation of consonants, and hypernasality. T.W., a 52 year old male, had very hypernasal speech following extensive maxillofacial surgery, for the removal of a tonsillar carcinoma. SNORS was successfully used as both an assessment and a therapy tool in the treatment of this patient. The effectiveness of conventional speech and language therapy vs. SNORS biofeedback therapy was compared. Initially, while there was some movement of the velum, the patient could not achieve velopharyngeal closure. Conventional therapy aimed to strengthen and improve the function of the velum and following this there was some minimal improvement: the patient could now achieve, but not maintain, closure. Reassessment, following a non-treatment period, showed little further change. SNORS biofeedback therapy was then given. This raised the patient's awareness of his velopharyngeal function, thus helping him to maintain closure, thereby reducing hypernasality. SNORS therapy proved significantly more effective than conventional speech and language therapy, in this case. Further intervention is outlined, and the benefits of multiparameter assessment of speech are discussed.

关键词：超级鼻腔-口腔比率测量系统、鼻音过重（高鼻音）、腭咽闭合不全、鼻化度、生物反馈治疗、颌面外科手术、单例个案研究

研究目标：解决颌面手术后结构性腭咽闭合不全导致的严重高鼻音在常规言语治疗下改善有限的问题，探讨以鼻口气流仪器进行客观评估并通过生物反馈进行治疗的可行性与疗效。

主要结论：SNORS 可同时作为评估与治疗工具；在本例中，SNORS 生物反馈治疗使患者能够维持腭咽闭合并显著减轻高鼻音，其效果明显优于常规言语语言治疗。

创新点：首次报道将商品化的鼻口气流比率测量系统 SNORS 同时用于颌面术后高鼻音的客观评估和实时生物反馈治疗，并在同一患者内对常规治疗与生物反馈治疗进行了对比。

后续建议：扩大样本，开展随机对照或交叉设计以验证单病例结论；增加长期随访以评估生物反馈疗效的维持情况；结合鼻咽内镜或鼻音计等其他客观指标进行多模态验证；探讨不同病因（神经性与结构性）VPI 患者对 SNORS 生物反馈的反应差异；开发家庭化或远程的 SNORS 生物反馈训练方案

APA 引文：Main, A., Kelly, S., & Manley, G. (1999). Instrumental assessment and treatment of hypernasality, following maxillofacial surgery, using SNORS: a single case study. International Journal of Language & Communication Disorders, 34(2), 223–238. https://doi.org/10.1080/136828299247559

仪器引用：SNORS was successfully used as both an assessment and a therapy tool in the treatment of this patient. The effectiveness of conventional speech and language therapy vs. SNORS biofeedback therapy was compared.

摘要 · 中文整理：本文介绍了 SNORS+ 的研制，这是一种面向临床、用户友好的言语构音器官测量仪器。仪器的设计准则基于对当前实践和可用技术的广泛回顾。SNORS+ 可对关键构音器官的功能及其协调性进行客观评估，从而能够有针对性地开展治疗。系统提供用于治疗的可视化反馈，并可方便地获得客观的结局测量。文中给出了初步结果，提示该仪器将在多种言语障碍的评估与管理中发挥极大作用。

原文摘要：This paper describes the development of SNORS+, a clinical, user-friendly instrument for measurement of the articulators during speech. The design criteria for the instrument were based upon a wide-ranging review of current practice and available techniques. SNORS+ allows objective assessment of the function and co-ordination of key articulators. Appropriate targeting of therapy is therefore possible. Visual feedback is provided, for therapy, and an objective measurement of outcome is easily obtained. Preliminary results are presented. These suggest that the instrument will prove extremely useful in the assessment and management of many speech disorders.

关键词：言语障碍、构音障碍、言语清晰度、计算机辅助诊断、人机界面、呼吸力学

研究目标：解决临床上缺乏一种无创、易用、能同时客观测量多个构音器官功能及其协调性的言语评估仪器的问题。

主要结论：研制出的 SNORS+ 能够客观评估关键构音器官的功能与协调，提供治疗用可视反馈并方便地获得客观结局测量；初步结果表明其在多种言语障碍的评估与管理中具有很高的实用价值。

创新点：在鼻口气流比率测量的基础上扩展为多参数同步测量系统，将客观评估、可视化生物反馈与结局测量集成于一台面向临床的用户友好仪器中。

后续建议：在更大规模、多种言语障碍人群中验证仪器的信度与效度；建立各参数的正常值数据库以支持临床判读；增加对唇、舌等更多构音器官的无创监测通道；开发自动化的参数提取与协调性量化算法；实现便携化与 USB 化以便于床旁和社区使用

APA 引文：Sharp, P., Kelly, S., Main, A., & Manley, G. (1999). An instrument for the multiparameter assessment of speech. Medical Engineering & Physics, 21(9), 661–671. https://doi.org/10.1016/s1350-4533(99)00091-0

仪器引用：This paper describes the development of SNORS+, a clinical, user-friendly instrument for measurement of the articulators during speech. ... SNORS+ allows objective assessment of the function and co-ordination of key articulators.