Wang Chi-Te, Liao Li-Jen, Huang Tsung-Wei, Lo Wu-Chia, Cheng Po-Wen
Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan; Oriental Institute of Technology, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Laryngoscope. 2015 May;125(5):1155-60. doi: 10.1002/lary.25088. Epub 2014 Dec 24.
OBJECTIVES/HYPOTHESIS: Office-based procedures have been proposed for the treatment of vocal polyps, including indirect laryngoscopic surgery and angiolytic laser photocoagulation. Our previous report documented good treatment outcomes by combining the two aforementioned procedures. This study was intended to further compare the treatment outcomes of office transnasal vocal fold polypectomy (VFP) with those of microlaryngoscopic surgery (MLS).
A matched cohort study.
This study retrospectively enrolled 50 age-, gender-, and size-matched patients with vocal polyps treated by VFP or MLS at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10-item voice-handicap index, maximal phonation time, subjective rating of voice quality, and videolaryngostroboscopic evaluation.
Both VFP and MLS resulted in significant clinical improvements 2 and 6 weeks postoperatively. Study results exhibited similar objective outcomes between VFP and MLS, whereas patients who received VFP reported higher subjective voice quality than those receiving MLS 2 weeks postoperatively. Six weeks after the procedures, the objective and subjective treatment outcomes were not significantly different between the two treatment groups.
This study shows that transnasal VFP may be used as an effective alternative treatment for small vocal polyps. Patients who received office VFP experienced rapid symptomatic relief with a higher degree of subjective effectiveness than MLS 2 weeks postoperatively, whereas the overall treatment outcomes showed a comparable level of effectiveness for both modalities.
3B.
目的/假设：已有人提出在门诊进行声带息肉治疗的方法，包括间接喉镜手术和血管溶解激光光凝术。我们之前的报告记录了将上述两种方法联合使用时良好的治疗效果。本研究旨在进一步比较门诊经鼻声带息肉切除术（VFP）与显微喉镜手术（MLS）的治疗效果。
一项匹配队列研究。
本研究回顾性纳入了2012年1月至2013年10月期间在一家三级教学医院接受VFP或MLS治疗的50例年龄、性别和息肉大小匹配的声带息肉患者。在手术前、术后2周和6周，通过嗓音质量的感知评分、语音信号的声学测量、10项嗓音障碍指数、最大发声时间、嗓音质量主观评分以及视频喉镜频闪评估来评估治疗效果。
VFP和MLS术后2周和6周均带来了显著的临床改善。研究结果显示VFP和MLS之间的客观结果相似，而接受VFP治疗的患者在术后2周报告的主观嗓音质量高于接受MLS治疗的患者。术后6周，两个治疗组之间的客观和主观治疗效果无显著差异。
本研究表明，经鼻VFP可作为小声带息肉的一种有效替代治疗方法。接受门诊VFP治疗的患者术后2周症状迅速缓解，主观有效程度高于MLS，而两种治疗方式的总体治疗效果显示出相当的有效性水平。
3B。
