Jensen Jane Bjerg, Rasmussen Niels
Biomedicinsk Institut, Københavns Universitet, 2200 Copenhagen N, Denmark.
Dan Med J. 2013 Feb;60(2):A4577.
This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds.
During the five-year period from 2003 to 2007, a total of 97 patients had PS for vocal fold polyps (n = 63), vocal fold cysts (n = 17), vocal fold nodules (n = 12) or vocal fold oedema (n = 5). Their average age was 41 years; 62% were women and 69% were smokers. Post-operative voice therapy was given to 45 patients. Post-operative clinical evaluation was available for data analysis in 89 patients (92%). Voice quality was assessed using the Multi-Dimensional Voice Program (MDVP), video-stroboscopy and self-reported assessment. The median follow-up time was 3.9 months.
Post-operative voice quality was reported as unaffected in 85%, improved but moderately affected in 13%, and severely affected in one patient with a cyst and vocal fold sulcus. Unaffected voice quality was obtained in 91% of patients not receiving voice therapy and in 77% of patients receiving voice therapy. All lesions except one polyp in the anterior commissure were completely removed. MDVP was performed both pre- and post-operatively in 22% of patients. The effect was a significant improvement of jitter (p = 0.013), shimmer (p = 0.001) and Soft Phonation Index (p = 0.013).
PS is a quick and effective treatment with uncommon and transient post-operative complications. Objective assessment of the voice pre- and post-operatively should be used consistently and applied in controlled studies evaluating the additional impact of pre- and post-operative voice therapy.
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本研究报告了我们对声带良性病变进行显微嗓音外科手术（PS）的经验。
在2003年至2007年的五年期间，共有97例患者因声带息肉（n = 63）、声带囊肿（n = 17）、声带小结（n = 12）或声带水肿（n = 5）接受了PS治疗。他们的平均年龄为41岁；62%为女性，69%为吸烟者。45例患者接受了术后嗓音治疗。89例患者（92%）有术后临床评估数据可供分析。使用多维度嗓音程序（MDVP）、视频频闪喉镜检查和自我报告评估来评估嗓音质量。中位随访时间为3.9个月。
据报告，85%的患者术后嗓音质量未受影响，13%的患者有所改善但仍受中度影响，1例患有囊肿和声带沟的患者受严重影响。未接受嗓音治疗的患者中有91%获得了未受影响的嗓音质量，接受嗓音治疗的患者中有77%获得了未受影响的嗓音质量。除前联合处的1个息肉外，所有病变均被完全切除。22%的患者在术前和术后均进行了MDVP检查。结果显示，抖动（p = 0.013）、闪烁（p = 0.001）和软起音指数（p = 0.013）均有显著改善。
PS是一种快速有效的治疗方法，术后并发症罕见且短暂。术前和术后应持续进行嗓音的客观评估，并应用于评估术前和术后嗓音治疗额外影响的对照研究中。
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