Wang Huizhong, Sun Fenglin, Man Rongjun, Geng Yang, Wang Xiao, Wang Haipeng, Gao Li, Xu Rong, Xia Yongjun
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Dec;28(24):1979-82.
To objectively evaluate the voice rehabilitation status in different period after treatment of Tis--T1 glottic carcinoma by CO2 laser with voice parameters.
A retrospective review of 41 cases with Tis--T1 glottic carcinoma treated by CO2 laser was performed, 23 cases were stage Tis (Tis group) and 18 cases with stage T1N0M0 (T1 group). The range of excision of the lesion by CO2 laser was according to the different stages of the tumor, and ensured theoperation negative margin was by intraoperative frozen pathological examination. We tested and compared the actual voice (coritaine F0, Jitter, Shimmer, NNE and MPT) of 30 cases of healthy middle-aged and old male(normal group) and all the patients at one day prior to operation, three months, six months and one year after operation respectively, which was to evaluate the voice rehabilitation status in different period after operation objectively.
Postoperative pathological examination revealed, 23 cases were squamous epithelium severe atypical hyperplasia, 16 cases were well differentiated squamous cell carcinoma, and 2 cases were moderately differentiated squamous cell carcinoma. Palatoglossal arch mucosal tear occurred in 3 patients. Respiratory difficulties were not seen in all cases, and normal oral feeding was obtained in all cases in postoperative three days. All patients were followed up for one year. There was statistical significance in F0, Jitter, Shimmer of both Tis group and T1 group after operation in different periods(P<0.05). But there was no statistical significance in NNE and MPT between six months and one years after operation in the two groups(P>0.05).
CO2 laser surgery is an effective treatment for early glottic carcinoma. Postoperative vocal function was improved in varying degrees, and voice quality gradually improved with the rehabilitation time. Partly objective parameters reflecting the vocal function gradually stabilized after half a year after operation.
采用嗓音参数客观评估二氧化碳激光治疗Tis - T1期声门型癌术后不同时期的嗓音康复状况。
回顾性分析41例采用二氧化碳激光治疗的Tis - T1期声门型癌患者，其中Tis期23例（Tis组），T1N0M0期18例（T1组）。二氧化碳激光对病变的切除范围依据肿瘤分期而定，术中冰冻病理检查确保手术切缘阴性。分别检测并比较30例健康中老年男性（正常组）以及所有患者术前1天、术后3个月、6个月和1年的实际嗓音（基频F0、微扰、振幅微扰、噪声能量和最长发声时间），以客观评估术后不同时期的嗓音康复状况。
术后病理检查显示，23例为鳞状上皮重度不典型增生，16例为高分化鳞状细胞癌，2例为中分化鳞状细胞癌。3例患者出现腭舌弓黏膜撕裂。所有病例均未出现呼吸困难，术后3天均能正常经口进食。所有患者均随访1年。Tis组和T1组术后不同时期的F0、微扰、振幅微扰差异均有统计学意义（P<0.05）。但两组术后6个月至1年的噪声能量和最长发声时间差异无统计学意义（P>0.05）。
二氧化碳激光手术是早期声门型癌的有效治疗方法。术后嗓音功能有不同程度改善，嗓音质量随康复时间逐渐提高。反映嗓音功能的部分客观参数术后半年后逐渐稳定。
