Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, South Korea.
Laryngoscope. 2013 Jul;123(7):1806-10. doi: 10.1002/lary.23456. Epub 2013 May 6.
OBJECTIVES/HYPOTHESIS: To investigate voice change as a complication after uvulopalatopharyngoplasty (UPPP) with or without radiofrequency tongue base reduction (RTBR) in patients with obstructive sleep apnea.
Before and after study.
Twenty-two patients with suspected velopharyngeal collapse only underwent uvulopalatopharyngoplasty (UPPP group). Twenty-five patients with velopharyngeal and retrolingual collapse underwent concurrent UPPP with RTBR (RTBR group). All patients were evaluated before surgery and at 8 weeks after surgery. Acoustic measures included mean fundamental frequency (mF0), maximal phonation time (MPT), jitter, shimmer, noise-to-harmonic ratio (NHR), hypernasality test, and the first three formant frequencies (F1, F2, F3) for sustained vowels. Voice handicap index (VHI) was used to determine subjective voice change.
Postoperative values for mF0, MPT, jitter, shimmer, NHR, hypernasality test, and F1 did not significantly change in either group following surgery. There were the significant decreases at the F2 of /u/ and the F3 of /o/ in the UPPP group, and at the F2 of /o/ and the F3 of /a/, /i/, and /o/ in the RTBR group. Postoperative VHI score was increased only in the RTBR group.
UPPP and UPPP with RTBR have an impact on formant frequencies of vowels. Despite a relatively small number of patients, it is apparent that UPPP with RTBR influences VHI. Patients, especially professional voice users, should be advised of this before considering the surgery.
目的/假设:研究悬雍垂腭咽成形术(UPPP)联合或不联合射频舌根减少术(RTBR)治疗阻塞性睡眠呼吸暂停患者术后声音变化的并发症。
前瞻性研究。
22 例怀疑软腭塌陷的患者仅行悬雍垂腭咽成形术(UPPP 组),25 例软腭和舌根后塌陷的患者行 UPPP 联合 RTBR(RTBR 组)。所有患者均在术前和术后 8 周进行评估。声学测量包括平均基频(mF0)、最长发声时间(MPT)、抖动、声扰、噪声与谐噪比(NHR)、鼻音亢进测试和/u/、/o/的前三个共振峰频率(F1、F2、F3)。嗓音障碍指数(VHI)用于评估主观嗓音变化。
术后,mF0、MPT、抖动、声扰、NHR、鼻音亢进测试和 F1 在两组中均无显著变化。UPPP 组/u/的 F2 和/o/的 F3,以及 RTBR 组/o/、/a/、/i/和/o/的 F2 和 F3 均显著降低。只有 RTBR 组术后 VHI 评分增加。
UPPP 和 UPPP 联合 RTBR 会影响元音的共振峰频率。尽管患者数量相对较少,但 UPPP 联合 RTBR 明显会影响 VHI。在考虑手术前,应告知患者,尤其是专业嗓音使用者。