Maximum phonation time, phonation quotient and mean air flow rate were measured in 250 normal and 501 pathological subjects. The normal group consisted of 200 school children of four age groups and 50 adults. The pathological group comprised, 122 cases of recurrent laryngeal nerve paralysis, 26 cases of sulcus vocalis, 59 cases of laryngitis, 182 cases of nodule and polyp, 36 cases of polypoid vocal cord, 18 cases of benign mass, 14 cases of epithelial hyperplasia, and 34 cases of carcinoma.
In 115 cases which received phonosurgical treatments, the change in the test values after the surgery was related to the patient's own evaluation of his voice. The results and conclusions are as follows:
1) The older the age was, the greater the average maximum phonation time was in the normal subjects. Clinically, a maximum phonation time of 7 seconds or less in a 1st grade child, 9 seconds or less in a 3 rd or 5 th grade child, or 10 seconds or less in a 7 th grade child or an adult can be considered abnormally short.
2) The older the age was, the greater the average phonation quotient was among the normal school children. The average phonation quotient for the normal adults was almost equal to that for 1 st or 3 rd grade children. Clinically, a phonation quotient of more than 260ml/sec in a 1 st or 3 rd grade child, 290ml/sec in a 5 th grade child 350ml/sec in a 7 th grade child, or 300ml/sec in an adult can be regarded as abnormally great.
3) The older the age was, the greater the average mean air flow rate measured with a respirometer for easy phonation was among the normal subjects. Clinically, a mean air flow rate of more than 170ml/sec in a 1 st grade child, 200ml/sec in a 3 rd grade child, 220ml/sec in a 5 th grade child, 240 m/sec in a 7 th grade child, or 300 ml/sec in a adult can be considered abnormally large.
4) Among the cases of various pathologies, those of recurrent laryngeal nerve paralysis presented abnormal test values most frequently. The glottic incompetence appears to account for the abnormal test values in many cases.
5) In the pathological cases, the frequency of abnormal test values was the greatest in the maximum phonation time and the least in the mean air flow rate.
6) High negative correlations were observed between the maximum phonation time and the phonation quotient in both the normal and pathological air flow rate, and the other two measures were not very high.
7) Among various laryngeal diseases, the test values agreed best with the patient's own evaluation of his voice in recurrent laryngeal nerve paralysis. Among the three test values, the maximum phonation time appeared to reflect best the patient's own evaluation of the postoperative change in his voice.
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