Schindler Antonio, Bottero Alessandro, Capaccio Pasquale, Ginocchio Daniela, Adorni Fulvio, Ottaviani Francesco
Dipartimento di Scienze Cliniche L. Sacco, L. Sacco Hospital, University of Milan, Milan, Italy.
J Voice. 2008 Jan;22(1):113-8. doi: 10.1016/j.jvoice.2006.08.004. Epub 2006 Oct 2.
Unilateral vocal fold paralysis (UVFP) is associated with changes in acoustic and aerodynamic voice measurements and can have a significant impact on a patient's quality of life. Few objective data regarding the efficacy of voice therapy for UVFP exist. The aim of this study was to retrospectively analyze voice modifications in a group of patients with UVFP before and after voice therapy. Forty patients with UVFP of different etiology were included in the study. Each subject had voice therapy with an experienced speech/language pathologist twice a week; the mean number of sessions was 12.6. A multidimensional assessment protocol was used; it included videoendoscopy, the maximum phonation time (MPT), the GIRBAS scale, spectrograms and a perturbation analysis, and the Voice Handicap Index (VHI). Pre- and posttreatment data were compared by means of the Wilcoxon and Student's t tests. A complete glottal closure was seen in 8 patients before voice therapy and in 14 afterward. Mean MPT increased significantly. In the perceptual assessment, the difference was significant for five out of six parameters. A significant improvement was found on spectrographic analysis; as for perturbation analysis, the differences in jitter, shimmer, and noise-to-harmonic ratio values were significant. VHI values showed a clear and significant improvement. A significant improvement of voice quality and quality of life after voice therapy is an often reached and reasonable goal in patients with UVFP.
单侧声带麻痹（UVFP）与声学和空气动力学嗓音测量的变化相关，并且会对患者的生活质量产生重大影响。关于UVFP嗓音治疗效果的客观数据很少。本研究的目的是回顾性分析一组UVFP患者在嗓音治疗前后的嗓音变化。40例不同病因的UVFP患者纳入本研究。每位受试者每周接受两次经验丰富的言语/语言病理学家的嗓音治疗；平均治疗次数为12.6次。采用多维评估方案；包括视频内镜检查、最长发声时间（MPT）、GIRBAS量表、声谱图和微扰分析以及嗓音障碍指数（VHI）。治疗前和治疗后的数据通过Wilcoxon检验和Student t检验进行比较。嗓音治疗前8例患者可见完全声门闭合，治疗后14例可见。平均MPT显著增加。在感知评估中，六个参数中的五个差异显著。声谱分析发现有显著改善；至于微扰分析，抖动、闪烁和噪声谐波比值的差异显著。VHI值显示出明显且显著的改善。嗓音治疗后嗓音质量和生活质量的显著改善是UVFP患者经常能够实现且合理的目标。
