Konomi Ujimoto, Watanabe Yusuke, Komazawa Daigo
Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Shinjuku-ku, Tokyo, Japan; Department of Otolaryngology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
Department of Otolaryngology, International University of Health and Welfare, Mita Hospital, Shinjuku-ku, Tokyo, Japan; Tokyo Voice Center, International University of Health and Welfare, Sanno Hospital, Minato-Ku, Tokyo, Japan.
J Voice. 2014 May;28(3):394.e5-12. doi: 10.1016/j.jvoice.2013.10.018. Epub 2013 Dec 15.
The purpose of this study was to figure out the application of pitch range (PR) evaluation subsequent to arytenoid adduction (AA) combined with type 1 thyroplasty (TP1) in unilateral vocal fold paralysis (UVFP).
Retrospective review of clinical records.
Subjects were 50 patients with UVFP for whom PR and maximum phonation time (MPT) could be evaluated before and 1 year after AA + TP1. Subjects were divided into two groups based on preoperative PR (pre-PR) (group 1: ≤1 semitone (ST); group 2: ≥2 ST). Correlations among pre-PR and post-PR, MPT, and age were assessed. We also evaluated PRs in subjects with PR deterioration and PRs by causative diseases.
PR was significantly extended from a median of 17.0-22.0 ST in all subjects. Pre-PR was correlated with post-PR. Post-PR correlated with post-MPT in group 2 but not in group 1. There was no correlation between post-PR and age or causative diseases. The mean change in PR among subjects with PR deterioration (28.0%, 14/50) was -3.6 ST. Pre-PR and the improvement of post-PR were negatively correlated in group 2.
PR evaluation can be useful for predicting post-PR. The effects of age and causative diseases were small compared with other factors, such as pre-PR width and surgical effects. The successful surgery may improve both PR and MPT. However, several cases showed obvious discrepancy of those postoperative improvements. It will be necessary to assess this discrepancy, particularly in subjects with postoperative voice insufficiency.
本研究旨在探讨在单侧声带麻痹（UVFP）患者中，杓状软骨内收术（AA）联合Ⅰ型甲状软骨成形术（TP1）后音高范围（PR）评估的应用。
对临床记录进行回顾性分析。
选取50例UVFP患者，在AA + TP1术前及术后1年评估其PR和最长发声时间（MPT）。根据术前PR（pre-PR）将患者分为两组（第1组：≤1半音（ST）；第2组：≥2 ST）。评估pre-PR与术后PR、MPT及年龄之间的相关性。我们还评估了PR恶化患者的PR以及不同病因导致的PR情况。
所有受试者的PR中位数从17.0 ST显著延长至22.0 ST。pre-PR与术后PR相关。术后PR在第2组与术后MPT相关，而在第1组则无相关性。术后PR与年龄或病因之间无相关性。PR恶化患者（28.0%，14/50）的PR平均变化为-3.6 ST。在第2组中，pre-PR与术后PR的改善呈负相关。
PR评估有助于预测术后PR。与其他因素（如pre-PR宽度和手术效果）相比，年龄和病因对PR的影响较小。成功的手术可能会改善PR和MPT。然而，部分病例在术后改善方面存在明显差异。有必要评估这种差异，尤其是在术后声音功能不全的患者中。
