Bryans Linda, Palmer Andrew D, Schindler Joshua S, Andersen Peter E, Cohen James I
Department of Otolaryngology-Head and Neck Surgery, Northwest Clinic for Voice and Swallowing, Oregon Health and Science University, Portland, OR 97239, USA.
Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
Ann Otol Rhinol Laryngol. 2013 Nov;122(11):707-16. doi: 10.1177/000348941312201108.
We compared the voice outcomes after cricotracheal resection (CTR) and airway dilation in adult women.
We performed long-term comprehensive voice assessments in 23 adult women treated for laryngotracheal stenosis, including acoustic and perceptual measurements of voice, videostroboscopy, the Voice Handicap Index, and an open-ended subjective questionnaire.
Voice measures were abnormal in both groups. Objective pitch and loudness measurements were significantly more impaired after CTR than after dilation. Perceptual ratings of voice were worse after CTR than after dilation, particularly with regard to breathiness, pitch, and loudness. The CTR group was more likely to report a voice disorder, reported significantly more voice symptoms, and had higher voice handicap scores. Videostroboscopy was frequently abnormal in both groups, with more evidence of vocal hyperfunction after CTR. Self-ratings of breathing and swallowing were generally high in both groups, but voice satisfaction was rated lower after CTR.
Voice was more significantly negatively impacted by CTR than by dilation. Surprisingly, many individuals in both groups reported improvements--a finding that possibly highlights the impact of laryngotracheal stenosis on airflow and vocal function before surgery. The importance of patient selection and preoperative counseling is emphasized, along with the potential need for voice therapy.
我们比较了成年女性行环状气管切除术（CTR）和气道扩张术后的嗓音结果。
我们对23例接受喉气管狭窄治疗的成年女性进行了长期全面的嗓音评估，包括嗓音的声学和感知测量、频闪喉镜检查、嗓音障碍指数以及一份开放式主观问卷。
两组的嗓音测量结果均异常。与扩张术后相比，CTR术后客观音高和响度测量受损更明显。CTR术后嗓音的感知评分比扩张术后更差，尤其是在呼吸声、音高和响度方面。CTR组更有可能报告嗓音障碍，报告的嗓音症状明显更多，且嗓音障碍评分更高。两组频闪喉镜检查结果经常异常，CTR术后有更多声带功能亢进的证据。两组对呼吸和吞咽的自我评分总体较高，但CTR术后嗓音满意度评分较低。
与扩张术相比，CTR对嗓音的负面影响更显著。令人惊讶的是，两组中的许多人都报告有改善——这一发现可能突出了喉气管狭窄对术前气流和嗓音功能的影响。强调了患者选择和术前咨询的重要性，以及嗓音治疗的潜在需求。
