Makeieff Marc, Barbotte Eric, Giovanni Antoine, Guerrier Bernard
Service ORL chirurgie Cervico-Faciale, Hôpital Gui de Chauliac, Université de Médecine, Montpellier, France.
Laryngoscope. 2005 Mar;115(3):546-51. doi: 10.1097/01.mlg.0000157848.78530.ee.
Supracricoid partial laryngectomy (SCPL) results in laryngeal preservation in more than 95% of patients with T2 glottic carcinoma. After surgery, glottis function is characterized by an absence of vocal cords and poor glottis closure. Voice is an important postSCPL quality of life factor.
Enhance postSCPL vocal function. Obtain postsurgical acoustic and aerodynamic measurements and correlate multiple objective parameters with perceptual results.
Continuous speech voice samples from 61 patients who had undergone SCPL more than 1 year before were scored according to the global, roughness, breathiness, asthenia, and strain (GRBAS) scale by a jury of listeners. Acoustic and aerodynamic parameters were recorded: fundamental frequency (F0), intensity, jitter, shimmer, signal-to-noise ratio (SNR), signal-to-noise ratio greater than 1 kHz (SNR>1), oral airflow (OAF), maximum phonation time (MPT), and estimated subglottic pressure (ESGP). Nonparametric tests and logistic regression analysis were used to compare objective measurements and perceptual evaluations.
All patients had various degrees of dysphonia: grade 1, 4.9%; grade 2, 55.7%; and grade 3, 39.4%. Correlations between perceptual grades and objective parameters were obtained for jitter, shimmer, SNR, SNR>1, ESGP, and OAF. No correlations were obtained between the different parameters and age, number of arytenoids, and time elapsed since surgery (TESS). Logistic regression analysis of jitter, SNR, ESGP, and OAF parameters revealed 92.6% agreement with the perceptual evaluation results.
环状软骨上部分喉切除术（SCPL）能使超过95%的T2声门型癌患者保留喉部。术后，声门功能的特点是声带缺失和声门闭合不佳。嗓音是SCPL术后生活质量的一个重要因素。
提高SCPL术后的嗓音功能。获得术后声学和空气动力学测量结果，并将多个客观参数与感知结果相关联。
由一组听众根据整体、粗糙、气息、虚弱和紧张（GRBAS）量表，对61例在1年多以前接受过SCPL手术的患者的连续语音样本进行评分。记录声学和空气动力学参数：基频（F0）、强度、抖动、闪烁、信噪比（SNR）、大于1kHz的信噪比（SNR>1）、口腔气流（OAF）、最长发声时间（MPT）和估计的声门下压力（ESGP）。采用非参数检验和逻辑回归分析来比较客观测量结果和感知评估结果。
所有患者均有不同程度的发声障碍：1级，4.9%；2级，55.7%；3级，39.4%。获得了抖动、闪烁、SNR、SNR>1、ESGP和OAF的感知等级与客观参数之间的相关性。不同参数与年龄、杓状软骨数量以及手术时间（TESS）之间未获得相关性。对抖动、SNR、ESGP和OAF参数进行逻辑回归分析，结果显示与感知评估结果的一致性为92.6%。
