Kluch Wiesław, Olszewski Jurek
Klinika Otolaryngologii i Onkologii Laryngologicznej, II Katedry Otolaryngologii UM w Łodzi.
Otolaryngol Pol. 2008;62(6):680-5. doi: 10.1016/S0030-6657(08)70339-1.
This work aimed at assessing effects of surgical treatment and post-operative rehabilitation of chronic hyper trophic laryngitis by videolaryngostroboscopy and the GRBAS scale.
The examinations were carrie on 50 patients of both sex, including 16 women (32.0%) and 34 men (68.0%) at the age of 19-66, surgically treated due t oedema hypertrophic lesions in the larynx. The voice was assessed by the perceptive GRBAS scale, a subjective voice self-assessment questionnaire, and through pre- and post-therapy videolaryngostroboscopic tests, which were also conducted afte phoniatric rehabilitation (30 days after the operation). Physical therapy (iontotherapy with hydrocortisone and 1% solutio of CaCl2) and respiratory and phonatory exercises were introduced in the rehabilitation.
The GRBAS scale indicate that the patients with the Reincke's oedema and vocal fold polyp showed greater voice improvement after the therapy an rehabilitation than those with chronic hypertrophic laryngitis. Contrary to the assessment carried out before the surgica procedure, the hoarseness level, rough voice, breathing voice, weak voice and tense voice mainly ranged between 0 and scale. In stroboscopy a correct marginal shift and occlusion of the glottis were noticed in each case after eliminating lesion like Reincke's oedema and vocal fold polyp (merely in 6.0% we found a disorder in the marginal shift). In the above patient their voice formation was unrestrained, 69.0% and 75.0% respectively, mid-location of the voice was normal in 92.0% an 88.0%, normal phonation time in 85.0% and 94.0%, and accurate voice setting in 77.0% and 75.0%. In stroboscopy the wors results of the voice assessment were obtained in the laryngeal papilloma patient.
The videolaryngostroboscop seems a perfect diagnostic method in larynx diseases, both in qualifying patients for a surgical treatment and monitorin effects of the treatment and post-operative rehabilitation.
本研究旨在通过电子喉镜频闪喉镜检查及GRBAS量表评估慢性肥厚性喉炎的手术治疗及术后康复效果。
对50例患者进行了检查，其中包括16名女性（32.0%）和34名男性（68.0%），年龄在19 - 66岁之间，因喉部水肿肥厚性病变接受手术治疗。通过GRBAS量表进行主观的嗓音自我评估问卷调查，并通过治疗前和治疗后的电子喉镜频闪喉镜检查评估嗓音，这些检查也在语音康复后（手术后30天）进行。康复过程中采用了物理治疗（氢化可的松离子导入疗法和1%氯化钙溶液）以及呼吸和发声练习。
GRBAS量表显示，患有莱因克水肿和声带息肉的患者在治疗和康复后嗓音改善程度大于慢性肥厚性喉炎患者。与手术前的评估相反，嘶哑程度、粗糙嗓音、呼吸性嗓音、微弱嗓音和紧张嗓音主要在0级和量表之间。在频闪喉镜检查中，在消除莱因克水肿和声带息肉等病变后，每例患者均观察到声门正确的边缘移位和闭合（仅6.0%的患者边缘移位出现紊乱）。在上述患者中，他们的嗓音形成不受限制，分别为69.0%和75.0%，嗓音的中位位置正常的分别为92.0%和88.0%，正常发声时间分别为85.0%和94.0%，准确的嗓音调整分别为77.0%和75.0%。在频闪喉镜检查中，喉乳头状瘤患者的嗓音评估结果较差。
电子喉镜频闪喉镜检查似乎是喉部疾病的一种完美诊断方法，既有助于确定患者是否适合手术治疗，又能监测治疗及术后康复效果。
