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脂肪填充前后声门闭合不全的磁共振成像评估、声学分析、发声功能及主观评分结果:与主观评分的相关性

Results of magnetic resonance imaging assessment, acoustic analysis, phonatory function and perceptual rating of glottic insufficiency before and after fat augmentation: correlated with subjective rating.

作者信息

Hsiung Ming-Wang, Chen Yen-Yu, Pai Lu, Lin Chao-Jung, Wang Hsing-Won

机构信息

Department of Otolaryngology, Tri-Service General Hospital, Taipei, Taiwan.

出版信息

ORL J Otorhinolaryngol Relat Spec. 2003 Mar-Apr;65(2):76-83. doi: 10.1159/000070770.

DOI:10.1159/000070770
PMID:12824728
Abstract

Autogenous fat augmentation has been proven effective in the treatment of glottic insufficiency (GI) using both subjective and objective methods of evaluation. However, no information is available in published research regarding the effectiveness and predictability of value parameters with regard to patients' perceptions and concerns. This article retrospectively examines the correlation between subjective and objective examinations and subjective ratings (SRs) in patients with presbylaryngis (n = 14) and sulcus vocalis (n = 2). Acoustic analysis, phonatory function, magnetic resonance imaging (MRI) assessment, and perceptual rating data were evaluated against SRs using pre- and postoperative test results in 16 patients. The mean time over which subjective and objective examinations were performed was 10 months. Twelve patients reported excellent results, while no change was observed in 4 patients. When compared against SR, the kappa value of jitter, shimmer, harmonic to noise ratio, phonation time, grade, roughness, breathiness, and MRI were 0.25, 0, -0.08, -0.11, -0.11, 0.18, 0, and 1, respectively. The agreement between the MRI and SR values was complete, and was the only relationship shown to be significant (p < 0.001). MRI assessment is an effective and reliable examination tool which can be considered for use in assessing the progress of the post-fat injection operation in GI patients during follow-up examinations. Furthermore, due to the excellent agreement between MRI assessment and the patients' subjective feelings, the SR value may serve as a good index of fat survival.

摘要

自体脂肪填充已被证明在治疗声门功能不全(GI)方面有效,采用了主观和客观的评估方法。然而,已发表的研究中没有关于价值参数在患者认知和关注点方面的有效性和可预测性的信息。本文回顾性研究了14例老年喉炎患者和2例声带沟患者主观检查与客观检查及主观评分(SR)之间的相关性。使用16例患者术前和术后的测试结果,对声学分析、发声功能、磁共振成像(MRI)评估和感知评分数据与SR进行了评估。主观和客观检查的平均时间为10个月。12例患者报告效果极佳,4例患者未见变化。与SR相比,抖动、闪烁、谐波噪声比、发声时间、等级、粗糙度、气息声和MRI的kappa值分别为0.25、0、-0.08、-0.11、-0.11、0.18、0和1。MRI值与SR值之间的一致性是完全的,并且是唯一显示出显著相关性的关系(p < 0.001)。MRI评估是一种有效且可靠的检查工具,可考虑用于在随访检查中评估GI患者脂肪注射术后的进展情况。此外,由于MRI评估与患者主观感受之间的良好一致性,SR值可能是脂肪存活的良好指标。

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引用本文的文献

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Glottic insufficiency caused by vocal fold atrophy with or without sulcus: systematic review of outcome measurements.声带萎缩伴或不伴沟导致的声门不全:结局测量的系统评价。
Eur Arch Otorhinolaryngol. 2024 Oct;281(10):5061-5074. doi: 10.1007/s00405-024-08751-5. Epub 2024 Jul 18.
2
Bilateral vocal fold injection with autologous fat in patients with vocal fold atrophy with or without sulcus.双侧声带自体脂肪注射治疗声带萎缩伴或不伴沟状声带。
Eur Arch Otorhinolaryngol. 2019 Jul;276(7):2007-2013. doi: 10.1007/s00405-019-05479-5. Epub 2019 May 27.
3
[Glottis injection to improve voice function : Review of more than 500 operations].
[声带注射改善嗓音功能:500 余例手术回顾]
HNO. 2015 Jul;63(7):489-96. doi: 10.1007/s00106-015-0029-2.
4
Technical considerations in fat augmentation for patients with glottic insufficiency.
Eur Arch Otorhinolaryngol. 2004 Nov;261(10):560-1. doi: 10.1007/s00405-004-0766-4. Epub 2004 Apr 29.