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循证医疗中用于喉部良性病变的频闪喉镜检查

Stroboscopy for benign laryngeal pathology in evidence based health care.

作者信息

Printza A, Triaridis S, Themelis C, Constantinidis J

机构信息

2 Otorhinolaryngology Department, Medical School, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece.

出版信息

Hippokratia. 2012 Oct;16(4):324-8.

Abstract

BACKGROUND AND AIMS

Voice disorders are common. The aim of this study is to evaluate the diagnostic value of stroboscopy for voice disorders related with benign pathology and apply results in evidence based health care.

METHODS

Prospective study. Tertiary care hospital. Voice Clinic. One hundred and fifty consecutive patients with an initial diagnosis of benign laryngeal disease or dysphonia of no clarified cause (normal laryngoscopy) were examined stroboscopically and studied prospectively until a final diagnosis was reached. Sixty-six men, eighty women and four children met the selection criteria for the study and had adequate follow-up. The initial laryngoscopic diagnosis was compared to the stroboscopic diagnosis. The diagnostic value of stroboscopy was rated at a scale of 0 to 3. A score 3 describes the diagnostic value of stroboscopy in the cases where the stroboscopic examination resulted to a change of the therapeutic modality offered to the patient.

RESULTS

For one third of the study's population the diagnostic value of stroboscopy was very significant, since it established the laryngeal pathology responsible for the voice disorder (28.8%) and for a small number of patients it changed the choice of treatment (4.7%). For about one third of the cases (32.2%) stroboscopy offered additional information regarding the cause of dysphonia. The diagnostic value of stroboscopy correlated with the type of laryngeal pathology.

CONCLUSIONS

Patients expected to benefit from stroboscopic examination are patients with small lesions of the vocal fold edge, dysphonic patients with unremarkable indirect laryngoscopy, and professional voice users.

摘要

背景与目的

嗓音障碍很常见。本研究旨在评估频闪喉镜检查对与良性病变相关的嗓音障碍的诊断价值,并将结果应用于循证医疗。

方法

前瞻性研究。三级医疗医院的嗓音诊所。对150例初诊为良性喉部疾病或病因不明的发音障碍(喉镜检查正常)的连续患者进行频闪喉镜检查,并进行前瞻性研究,直至得出最终诊断。66名男性、80名女性和4名儿童符合研究入选标准并得到充分随访。将最初的喉镜诊断与频闪喉镜诊断进行比较。频闪喉镜检查的诊断价值按0至3级评定。3分描述频闪喉镜检查在导致对患者提供的治疗方式发生改变的情况下的诊断价值。

结果

对于三分之一的研究人群,频闪喉镜检查的诊断价值非常显著,因为它确定了导致嗓音障碍的喉部病变(28.8%),并且对少数患者改变了治疗选择(4.7%)。对于约三分之一的病例(32.2%),频闪喉镜检查提供了有关发音障碍病因的额外信息。频闪喉镜检查的诊断价值与喉部病变类型相关。

结论

预计将从频闪喉镜检查中受益 的患者是声带边缘有小病变的患者、间接喉镜检查无异常的发音障碍患者以及职业用嗓者。

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