美国 KayPENTAX 言语发声空气动力学系统 6600

摘要 · 中文整理：目的：全面了解轻症COVID-19感染对嗓音的影响、持续时间及其潜在因素。方法：纳入10例轻症COVID-19患者和10名20–40岁健康对照，在症状出现后第15、30和60天分别进行主观（嗓音障碍指数、反流症状指数）、声学（基频、jitter、shimmer、谐噪比、声压级）和空气动力学（发声阈压、发声阈流、气流阻力、气流效率、平均呼气气流、最长发声时间、最响发声时间）测量。结果：第60天主观评分恢复正常，但shimmer与发声阈压较对照显著升高，谐噪比与气流阻力显著降低。结论：COVID-19感染对嗓音产生有不利影响；尽管主观不适可在发病后2个月内逐渐消退，但发声方式的改变可能延迟出现。

原文摘要：Objective: To gain a comprehensive understanding of the vocal repercussions experienced by mild COVID-19 infection, as well as the duration and underlying factors contributing to these effects. Methods: Ten patients with mild COVID-19 and ten healthy controls aged 20-40 years were enrolled. Subjective (Voice Handicap Index and Reflux Symptom Index), acoustic (fundamental frequency, jitter, shimmer, harmonic-to-noise ratio, sound pressure level) and aerodynamic (phonation threshold pressure, phonation threshold flow, airflow resistance, airflow efficiency, mean expiration airflow, maximum phonation time, maximum loudest phonation time) measurements were performed on day 15, day 30 and day 60 after symptom onset. Results: On day 60, subjective scores had returned to normal, whereas shimmer and phonation threshold pressure were significantly increased and harmonic-to-noise ratio and airflow resistance were significantly decreased compared with controls. Conclusions: Our study demonstrated that COVID-19 infection has a detrimental effect on voice production. Although subjective discomfort may gradually subside within 2 months after onset, alterations in phonation mode can be delayed.

关键词：声学、空气动力学、新型冠状病毒肺炎、后遗症、嗓音

研究目标：探讨轻症COVID-19感染对嗓音功能的影响及其持续时间，明确主观症状消退后是否仍存在客观声学与空气动力学改变。

主要结论：轻症COVID-19患者主观嗓音不适在2个月内消退，但第60天仍存在shimmer、发声阈压升高及谐噪比、气流阻力降低，提示发声模式改变可能延迟出现并增加功能性嗓音障碍风险。

创新点：首次在同一队列中于三个时间点纵向联合应用主观量表、Praat声学分析与PAS 6600空气动力学测量追踪轻症COVID-19后的嗓音恢复过程。

后续建议：扩大样本量并延长随访至6个月以上以判断改变是否持续；加入喉镜检查以明确空气动力学改变的结构或功能基础；按病毒变异株、疫苗接种状态分层分析；增加嗓音使用职业人群的亚组研究

APA 引文：Xiao, Z.-X., Ren, Q.-Y., Liang, W.-Q., Li, N.-N., Huang, N., Zhu, Z.-X., Ge, P.-J., Zhang, S.-Y., & Kang, J. (2025). Follow-up of patients with mild COVID-19 using subjective, acoustic, and aerodynamic measurements. World Journal of Otorhinolaryngology - Head and Neck Surgery, 11(3), 400-405. https://doi.org/10.1002/wjo2.234

仪器引用：The Phonatory Aerodynamic System Model 6600 (KayPENTAX, Montvale, New Jersey) was used to analyze aerodynamic parameters: phonation threshold pressure (PTP), phonation threshold flow (PTF), airflow resistance (AR), airflow efficiency (AE), mean expiration airflow (MEA), maximum phonation time (MPT), and maximum loudest phonation time (MLPT).

摘要 · 中文整理：发声需要在不同声压级与频率下频繁起始与停止。既往采用经口硬性内镜喉镜的研究显示，正常与异常受试者之间振动延迟时长存在差异，但由于使用硬性内镜观察喉部，这些研究并不符合生理状态。本研究采用一种改良方法，在进行经鼻高速内镜摄像的同时采集声压、基频、气流率与声门下压。研究旨在考察嗓音正常男女在变声压级起音过程中的起音模式，并将其与声学和空气动力学数据相关联。材料与方法：对 3 名健康男性与 3 名健康女性进行高速喉镜与同步记录，要求其以轻、中、响三种响度发出 [pa:pa:] 音势。纤维内镜穿过气流头面罩，以实现声学与空气动力学数据的同步记录与分析。结果：全组声压级平均升高 15 dB，由 70 dB 升至 85 dB；基频平均升高 10 Hz。随声压级升高，2 名受试者气流增加、2 名减少、2 名保持不变。声门下压由轻声到响声呈稳定上升。与轻声到中等响度相比，中等到响声阶段的声门阻力显著增加。频闪影像分析显示，所有浊音样本的振动起始均无需声门完全闭合。响声发声时振幅更大、起振更快且声门周期闭合时间延长，但达到目标声压级所需周期数更多；响声发声存在更长的闭合相。对频闪波形信号的快速傅里叶变换分析显示，响声发声时基频之上的二次与三次谐波能量更为显著。咽部调节增加，表现为舌根倾斜、声带缩短与咽腔收缩。结论：各种发声方式下的起音均无需声门完全闭合；响声发声的声门阻力增幅明显大于轻声或中等响度。起音振动分析显示，响声发声需要更长时间才能使振荡稳定到稳态。随声压级升高，声道调节出现显著变化，最明显的是舌肌张力增加伴会厌后移；响声发声时的发声前时间延长。随响度增加出现的喉部挤压、声带缩短与会厌倾斜等肌紧张性发声障碍模式是响声发声的特征。上述观察表明，柔性高速喉镜可揭示硬性喉镜无法观察到的现象，并可在选定病例中对数字频闪信号进行客观分析。

原文摘要：Voicing: requires frequent starts and stops at various sound pressure levels (SPL) and frequencies. Prior investigations using rigid laryngoscopy with oral endoscopy have shown variations in the duration of the vibration delay between normal and abnormal subjects. However, these studies were not physiological because the larynx was viewed using rigid endoscopes. We adapted a method to perform to perform simultaneous high-speed naso-endoscopic video while simultaneously acquiring the sound pressure, fundamental frequency, airflow rate, and subglottic pressure. This study aimed to investigate voice onset patterns in normophonic males and females during the onset of variable SPL and correlate them with acoustic and aerodynamic data. Materials and Methods: Three healthy males and three healthy females were studied by simultaneous high-speed video laryngoscopy and recording with the production of the gesture [pa:pa:] at soft, medium, and loud voices. The fiber optic endoscope was threaded through a pneumotachograph mask for the simultaneous recording and analysis of acoustic and aerodynamic data. Results: The average increase in the sound pressure level (SPL) for the group was 15 dB, from 70 to 85 dB. The fundamental frequency increased by an average of 10 Hz. The flow was increased in two subjects, reduced in two subjects, and remained the same in two subjects as the SPL increased. There was a steady increase in the subglottic pressure from soft to loud phonation. Compared to soft to medium phonation, a significant increase in glottal resistance was observed with medium-to-loud phonation. Videokymogram analysis showed the onset of vibration for all voiced tokens without the need for full glottis closure. In loud phonation, there is a more rapid onset of a larger amplitude and prolonged closure of the glottal cycle; however, more cycles are required to achieve the intended SPL. There was a prolonged closed phase during loud phonation. Fast Fourier transform (FFT) analysis of the kymography waveform signal showed a more significant second- and third-harmonic energy above the fundamental frequency with loud phonation. There was an increase in the adjustments in the pharynx with the base of the tongue tilting, shortening of the vocal folds, and pharyngeal constriction. Conclusion: Voice onset occurs in all modalities, without the need for full glottal closure. There was a more significant increase in glottal resistance with loud phonation than that with soft or middle phonation. Vibration analysis of the voice onset showed that more time was required during loud phonation before the oscillation stabilized to a steady state. With increasing SPL, there were significant variations in vocal tract adjustments. The most apparent change was the increase in tongue tension with posterior displacement of the epiglottis. There was an increase in pre-phonation time during loud phonation. Patterns of muscle tension dysphonia with laryngeal squeezing, shortening of the vocal folds, and epiglottis tilting with increasing loudness are features of loud phonation. These observations show that flexible high-speed video laryngoscopy can reveal observations that cannot be observed with rigid video laryngoscopy. An objective analysis of the digital kymography signal can be conducted in selected cases.

关键词：高速喉镜摄像、起音、频闪影像描记、发声功能

研究目标：解决硬性喉镜研究发声起始时不符合生理状态的问题，建立柔性高速鼻内窥喉镜与PAS空气动力学同步采集方法，并探讨不同响度下正常人发声起始的振动模式与空气动力学关系。

主要结论：发声起始无需完全声门闭合；声门阻力随响度增加呈非线性上升，中→响增幅显著更大；响声起振需更多周期达稳态且伴随舌根后移、会厌倾斜等声道调整；该同步方法可行并可在特定病例中做客观波形图分析。

创新点：将柔性纤维喉镜穿过PAS气流面罩并密封，实现高速视频喉镜（2000 fps）与声学、气流、声门下压的真正同步采集，突破了以往硬镜研究的生理局限。

后续建议：扩大样本并纳入肌紧张性发声障碍等患者以验证病理模式；加入电声门图以增加振动相位的客观参考；改进面罩开孔与密封设计并量化漏气对气流测量的影响；开发自动化波形图起振周期与闭合相的算法以减少人工判读

APA 引文：Woo, P. (2024). Simultaneous high-speed video laryngoscopy and acoustic aerodynamic recordings during vocal onset of variable sound pressure level: A preliminary study. Bioengineering, 11(4), 334. https://doi.org/10.3390/bioengineering11040334

仪器引用：Instructions were provided using a phonatory aerodynamic system (PAS, Model 6600, Version 3.4.1; Pentax Medical, Montvale, NJ, USA). Fiberoptic laryngoscopy was performed using a high-speed camera. A voicing efficiency recording protocol was used in the PAS. The sensors allowed for the sampling of voice fundamental frequency, sound pressure level, mean airflow rate, and subglottic pressure.

摘要 · 中文整理：背景：由于医疗可及性问题及COVID-19疫情，远程治疗和数字化治疗的需求增加，但在许多国家远程治疗仍很少开展。本初步研究旨在描述功能亢进性嗓音障碍患者远程治疗的详细过程并考察其效果。方法：纳入3例功能亢进性嗓音障碍患者，评估以面对面方式进行，包括听感知评估、声学评估、空气动力学评估、患者自评和访谈；治疗通过智能手机应用以远程方式实施。结果：在听感知、声学、空气动力学和患者自评的定量分析中，所有受试者治疗后嗓音均有改善；并通过访谈对远程治疗进行了深入分析。结论：远程治疗对嗓音障碍患者有效，患者对该方式满意。除本初步研究外还需更大规模研究，但在医疗可及性受限或呼吸道传染病暴发时，远程医疗可能改善治疗效果和患者满意度。

原文摘要：Background: The need for telepractice and digital treatment has increased due to issues regarding medical access and the COVID-19 pandemic. However, in many countries, telepractice is rarely performed. The purpose of this pilot study was to describe the detailed process of telepractice in patients with hyperfunctional voice disorder and investigate its effects. Methods: The three subjects who were enrolled in this pilot study had hyperfunctional voice disorders. The evaluation was performed face to face. Auditory perceptual evaluation, acoustic evaluation, aerodynamic evaluation, patient self-evaluation, and interviews were conducted. Treatment was delivered by telepractice using a smartphone application. Results: In quantitative analysis of auditory perceptual evaluation, acoustic evaluation, aerodynamic evaluation, and patient self-evaluation, all subjects showed improved voice after treatment. In-depth analysis of telepractice was performed through the interview. Conclusions: Telepractice was effective in patients with voice disorders, and the patients were satisfied with this approach. In addition to this pilot study, further large-scale studies are required, but telemedicine may improve treatment outcomes and patient satisfaction in cases where medical access is limited or during outbreaks of respiratory infections like COVID-19.

关键词：远程治疗、数字化治疗、嗓音障碍、嗓音治疗

研究目标：探讨在医疗可及性受限背景下，通过智能手机应用开展远程嗓音治疗对功能亢进性嗓音障碍患者是否有效，并详细描述其实施流程。

主要结论：3例患者治疗后GRBAS、声学参数、空气动力学参数（MPT延长、MAFR与Psub趋于正常）及VHI均改善，患者满意并倾向于远程方式，提示远程嗓音治疗可行且有效。

创新点：在韩国率先系统描述并验证了基于智能手机应用的远程嗓音治疗流程，采用多维（听感知、声学、PAS空气动力学、自评、访谈）指标评价疗效。

后续建议：开展随机对照试验比较远程与面对面治疗的等效性；扩大样本并纳入男性及不同职业嗓音使用者；将空气动力学评估也迁移到家庭端便携设备以实现全程远程；增加治疗后随访以评估疗效维持情况

APA 引文：Choi, N., Park, S., & Lee, G. J. (2024). Effectiveness of voice therapy in telepractice with patients with hyperfunctional voice disorder: A pilot study. Journal of Clinical Medicine, 13(17), 5320. https://doi.org/10.3390/jcm13175320

仪器引用：A Phonatory Aerodynamic System (PAS; Model 6600, Kay Pentax) (Lincoln Park, NJ, USA) was used to evaluate the respiration and phonation ability of the participants, measuring the maximum phonatory time (MPT), the mean airflow ratio (MAFR), and the subglottal pressure (Psub).

摘要 · 中文整理：单侧声带麻痹（UVFP）源于喉肌功能障碍并损害嗓音空气动力学。本研究对134例不累及环甲肌的UVFP患者进行定量喉肌电图（LEMG）与空气动力学分析，探讨喉肌功能障碍如何影响嗓音空气动力学。结果显示甲杓肌-环杓侧肌（TA-LCA）复合体的turn ratio是气流和功率下降、效率提高的稳健因素，环甲肌对称性改善了空气动力学阻力。保留的TA-LCA功能减少发声时的漏气，而对称的环甲肌激活增强喉阻力。TA-LCA复合体的残余功能有助于减少漏气、减轻发声努力度并提升空气动力学效率。

原文摘要：Unilateral vocal fold paralysis (UVFP) results from dysfunction of the laryngeal muscles and impairs voice aerodynamics. This study examined how laryngeal muscle dysfunction affects voice aerodynamics using quantitative laryngeal electromyography (LEMG) and aerodynamic analysis in 134 UVFP patients without cricothyroid involvement. The turn ratio of TA-LCA muscles was a robust factor in the decrease in airflow and power while increasing efficiency, and cricothyroid muscle symmetry improved aerodynamic resistance. Preserved thyroarytenoid-lateral cricoarytenoid (TA-LCA) function reduces air leakage during phonation, whereas symmetric cricothyroid activation enhances laryngeal resistance. The residual function of the TA-LCA muscle complexes facilitates less air leakage and alleviates voice effort, enhancing aerodynamic efficiency.

关键词：单侧声带麻痹、喉肌电图、空气动力学

研究目标：明确单侧声带麻痹患者喉肌（TA-LCA与环甲肌）神经肌肉功能的定量指标与发声空气动力学参数之间的关系，解释病理性气流泄漏与效率下降的神经肌肉机制。

主要结论：UVFP患者经喉气流、口内压与功率升高、效率下降；TA-LCA残余功能越好，气流和功率越低、效率越高；环甲肌双侧对称激活可提高喉阻力，TA-LCA失神经会引起环甲肌代偿性不对称。

创新点：首次在大样本（134例）UVFP患者中将定量喉肌电图turn分析与PAS 6600空气动力学参数进行回归关联，揭示了残余神经肌肉功能对空气动力学效率的贡献。

后续建议：纳入治疗（注射填充或甲状软骨成形术）前后的纵向数据，检验空气动力学参数对疗效的敏感性；结合高速喉镜或声门面积测量以直接验证漏气机制；增加健康对照的同步喉肌电图数据以建立正常turn ratio参考；探讨声学参数与空气动力学参数的联合预测模型

APA 引文：Chung, W.-L., Liu, K.-C., Chuang, H.-F., Lu, Y.-A., Li, H.-Y., Wong, A. M. K., Pei, Y.-C., & Fang, T.-J. (2022). Aerodynamic performance and neuromuscular control in patients with unilateral vocal fold paralysis. Diagnostics, 12(12), 3124. https://doi.org/10.3390/diagnostics12123124

仪器引用：Aerodynamic analysis for the voice was performed using the voicing efficiency protocol of the Phonatory Aerodynamic System (PAS) Model 6600 device (KayPENTAX Corp).

摘要 · 中文整理：发声空气动力学测量系统（PAS Model 6600）是一种用于评估嗓音疾病手术干预、治疗与康复效果的评价仪器，可与其他感知与仪器方法互为补充，用于嗓音疾病评估。建立常模数据十分重要，因为使用恰当的常模是保证诊断与描述准确性的必要条件。因此，本研究的首要目标是在健康成年土耳其语使用者中建立 KayPENTAX PAS Model 6600 所测发声空气动力学参数的成人常模数据库，并进一步检验年龄、性别及年龄—性别交互变量对这些参数的影响。本研究的贡献在于首次针对 PAS 五个协议下除平均音高之外的全部测量项生成常模数据。研究纳入 206 名嗓音正常的健康土耳其语使用者（106 名女性、100 名男性），并分为三个年龄组。研究采集了五个 PAS 协议（肺活量、最长持续发声、舒适持续发声、声压级变化与发声效率）下的 45 项发声空气动力学参数，并对这 45 项参数分析了年龄、性别与年龄—性别交互变量。结果显示，分别有 30 项与 19 项参数存在显著的性别与年龄效应，仅 6 项参数出现性别—年龄交互作用，其余 10 项参数未见显著差异。共有 35 项作为嗓音客观临床评估重要组成部分的发声与空气动力学参数呈现显著的年龄与性别效应。因此，用作嗓音评估参照的常模数据应按年龄与性别差异分别生成。

原文摘要：Phonatory Aerodynamic System (PAS Model 6600) is an evaluation instrument that assesses the effectiveness of surgical interventions, treatments, and therapy for voice disorders. It can be used for the assessment of voice disorders by supporting other perceptual and instrumental methods. It is important to establish normative data, because the use of appropriate norms is necessary for diagnostic and descriptive accuracy. Therefore, this study is aimed primarily at establishing adult normative databases for phonatory aerodynamic measures obtained with the KayPENTAX PAS Model 6600 among healthy adult Turkish speakers and then examining the effect of age, gender, and age-gender interaction variables on these measures. The contribution of the study is considered so important since it will generate normative data for all measurements—except the mean pitch—by the five protocols of PAS for the first time. Two hundred and six healthy Turkish speakers with normal voice (106 women and 100 men) were included in the study and stratified into three age groups. Forty-five phonatory aerodynamic measures across five PAS protocols (vital capacity, maximum sustained phonation, comfortable sustained phonation, variation in sound pressure level, and voicing efficiency) were collected. Age, gender, and age-gender interaction variables were analyzed for 45 PAS parameters. Significant gender and age effect was found for 30 and 19 variables, respectively. Gender-age interaction together was observed for only 6 parameters. Significant differences were not found for the remaining 10 parameters. Significant age and gender effects were observed for 35 phonatory and aerodynamic measures which are essential part of the objective clinical assessment of voice. Consequently, normative data used as reference in voice assessment should be generated according to age and gender differences.

关键词：发声空气动力学、常模数据、发声空气动力学测量系统（PAS Model 6600）、嗓音评估、年龄与性别效应、土耳其语使用者

研究目标：土耳其语人群缺乏基于PAS 6600的嗓音声学与空气动力学常模数据，临床评估无本土参考值；本文旨在建立该人群分年龄、分性别的常模，并明确年龄与性别对各参数的影响。

主要结论：在45项参数中，30项存在显著性别差异、19项存在显著年龄差异、6项存在交互作用；男性气流量更高、女性基频更高、声压级与空气动力学阻力随年龄增加，说明常模参考数据必须按年龄与性别分层。

创新点：首次为土耳其语健康成人建立覆盖PAS五个协议、45项参数的大样本（206人）常模数据库，并系统分析了性别、年龄及其交互作用。

后续建议：扩大老年组样本量并纳入80岁以上人群以完善老年常模；增加跨语言对比，检验语言背景对空气动力学常模的影响；增加重测信度评估以量化PAS参数的个体内变异；补充嗓音障碍患者组数据以验证常模的临床区分效度

APA 引文：Şen, A. Z., & Toğram, B. (2021). The normative study of acoustic and aerodynamic characteristics of voice among healthy adult Turkish speaker population. BioMed Research International, 2021, 9217236. https://doi.org/10.1155/2021/9217236

仪器引用：In this study, PAS Model 6600 was used to obtain acoustic and aerodynamic data from the participants. The PAS is a computer-based software and hardware system designed to measure airflow, air pressure, and other acoustic and aerodynamic characteristics about voice.