Saarinen Antti, Sovijärvi Anssi R A, Karhumäki Lauri, Rihkanen Heikki
Department of Respiratory Medicine, Central Finland Health Care District, Kinkomaa Hospital, 40930, Kinkomaa, Finland.
Eur Arch Otorhinolaryngol. 2007 Nov;264(11):1323-7. doi: 10.1007/s00405-007-0385-y. Epub 2007 Jul 17.
Injection laryngoplasty restores voice in subjects with unilateral vocal fold paralysis, but knowledge of its effects on airflow dynamics is limited. Impulse oscillometry (IOS) is a non-invasive technique to investigate airway resistance. It is easily performed during normal breathing. A prospective study was conducted in order to investigate the effects of autologous fascia injection on airflow dynamics. IOS, flow-volume spirometry, acoustic analysis of voice, voice handicap index (VHI) questionnaire and subjective dyspnoea score were recorded before and 5-11 months after the operation. There was no significant change in respiratory resistance (Rres) or other variables of IOS. FEV1/FVC decreased from 0.80 to 0.77 (P = 0.02), but other variables of spirometry did not change significantly. Acoustic properties of voice (noise-to-harmonics ratio, shimmer, jitter, maximal phonation time) and VHI improved significantly. No change in dyspnoea occurred. In conclusion, medializing of a paralysed vocal fold improves voice, but does not have a clinically significant adverse effect on breathing. Flow-volume spirometry is more sensitive than IOS to changes in airflow dynamics after medialization.
注射喉成形术可恢复单侧声带麻痹患者的嗓音,但关于其对气流动力学影响的了解有限。脉冲振荡法(IOS)是一种用于研究气道阻力的非侵入性技术。在正常呼吸过程中易于操作。为了研究自体筋膜注射对气流动力学的影响,进行了一项前瞻性研究。记录了术前以及术后5 - 11个月的IOS、流量-容积肺活量测定、嗓音声学分析、嗓音障碍指数(VHI)问卷和主观呼吸困难评分。IOS的呼吸阻力(Rres)或其他变量没有显著变化。第一秒用力呼气容积/用力肺活量(FEV1/FVC)从0.80降至0.77(P = 0.02),但肺活量测定的其他变量没有显著变化。嗓音的声学特性(噪声与谐波比、声门颤动、基频微扰、最大发声时间)和VHI有显著改善。呼吸困难没有变化。总之,麻痹声带的内移改善了嗓音,但对呼吸没有临床上显著的不良影响。流量-容积肺活量测定比IOS对声带内移后气流动力学的变化更敏感。