Hsiung Ming-Wang, Lu Pai, Kang Bor-Hwang, Wang Hsing-Won
Department of Otolaryngology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
J Laryngol Otol. 2003 Jun;117(6):478-81. doi: 10.1258/002221503321892334.
Voice disorders can cause problems for patients emotionally, physically, economically and functionally. Neither subjective nor objective voice examinations are able to evaluate such factors adequately. For this study, a retrospective analysis of 79 dysphonic cases was conducted using the voice handicap index (VHI) to gather comprehensive data across a variety of voice disorders. Of the 79 cases, 41 involved glottic insufficiency, 26 involved vocal polyps or mass, and 12 involved functional voice disorders. Cases were assessed with the VHI using physical (P), functional (F), emotional (E) parameters and a total (T) of the three. P, F, E and T variables were entered into a statistical programme and analysed using one-way analysis of variance (ANOVA). Mean +/-SE values for P, F, E and T, respectively, in glottic insufficiency cases were 31.61 +/- 1.10, 26.49 +/- 1.43, 26.06 +/- 1.54, and 84.20 +/- 4.21. Mean +/-SE values for P, F, E and T, respectively, in vocal mass cases were 30.69 +/- 1.73, 25.23 +/- 1.90, 23.96 +/- 1.82, and 79.88 +/- 5.08. The mean +/-SE values of P, F, E and T, respectively, in functional voice disorders were 20.92 +/- 2.06, 18.33 +/- 1.82, 16.83 +/- 1.86, and 56.08 +/- 5.23. We found the mean glottic insufficiency was significantly greater than functional voice disorders for each measure. There were significant differences between vocal mass and functional voice disorders means for P and T. Glottic insufficiency and vocal mass means were not significantly different for any measure. Problems in the physical realm were identified as the most severe amongst all patients. Glottic insufficiency patients were found to suffer the most in every VHI value. Although VHI is a relatively new method by which to measure discomfort in voice-disordered patients, it provides a mechanism for patients to define their discomfort and for therapists to better target recovery programmes to patient's needs.
嗓音障碍会在情感、身体、经济和功能方面给患者带来问题。主观和客观的嗓音检查都无法充分评估这些因素。在本研究中，我们使用嗓音障碍指数（VHI）对79例发声困难病例进行了回顾性分析，以收集各种嗓音障碍的综合数据。在这79例病例中，41例涉及声门闭合不全，26例涉及声带息肉或肿物，12例涉及功能性嗓音障碍。使用VHI通过身体（P）、功能（F）、情感（E）参数以及这三者的总和（T）对病例进行评估。将P、F、E和T变量输入统计程序，并使用单因素方差分析（ANOVA）进行分析。在声门闭合不全病例中，P、F、E和T的平均±标准误值分别为31.61±1.10、26.49±1.43、26.06±1.54和84.20±4.21。在声带肿物病例中，P、F、E和T的平均±标准误值分别为30.69±1.73、25.23±1.90、23.96±1.82和79.88±5.08。在功能性嗓音障碍病例中，P、F、E和T的平均±标准误值分别为20.92±2.06、18.33±1.82、16.83±1.86和56.08±5.23。我们发现，在各项测量中，声门闭合不全的平均值显著高于功能性嗓音障碍。在P和T方面，声带肿物与功能性嗓音障碍的平均值存在显著差异。在任何测量中，声门闭合不全和声带肿物的平均值均无显著差异。在所有患者中，身体方面的问题被确定为最为严重。声门闭合不全患者在每个VHI值上的痛苦程度最高。尽管VHI是一种相对较新的用于测量嗓音障碍患者不适程度的方法，但它为患者提供了一种界定自身不适程度的机制，也为治疗师根据患者需求更好地制定康复计划提供了依据。
