Divakaran Shilpa, Alexander Arun, Vijayakumar Sabarinath, Saxena Sunil Kumar
Pondicherry Institute of Medical Sciences, Pondicherry, India.
JIPMER, Pondicherry, India.
Indian J Otolaryngol Head Neck Surg. 2015 Dec;67(4):361-5. doi: 10.1007/s12070-015-0853-4. Epub 2015 May 23.
Very few studies have been conducted in South Indian population to evaluate glottic function and voice outcome following carbon dioxide (CO2) laser assisted microsurgery for benign lesions of the larynx. This is a descriptive study which aims at assessing the voice outcome (perceptual and acoustic) and vocal fold function (stroboscopic) following CO2 laser excision in benign vocal fold lesions. 50 adult patients with benign laryngeal lesions were selected to undergo CO2 laser excision in super-pulse mode at power setting of 6 watts. Perceptual analysis was done using GRBAS score. Voice analysis was done using Praat software and fundamental frequency, jitter, shimmer and harmonics to noise ratio were assessed. Stroboscopy was done to evaluate vocal fold function using glottic closure and mucosal wave pattern as parameters. Evaluation of these parameters was done pre-operatively and at 2, 6 weeks and 3 months post-operatively. Perceptual analysis revealed a significant improvement in the GRBAS score after surgery (p < 0.001). Acoustic analysis showed that all the parameters improved significantly after surgery (p < 0.001). Stroboscopy showed that vocal fold function improved in 98 % of patients in terms of completeness of glottic closure and regular, periodic mucosal wave. Super-pulse micro-spot carbon dioxide laser is a safe and effective treatment option for benign lesions of vocal folds, with excellent voice outcome.
在南印度人群中,针对二氧化碳(CO2)激光辅助显微手术治疗喉部良性病变后的声门功能和嗓音结果进行的研究非常少。这是一项描述性研究,旨在评估二氧化碳激光切除良性声带病变后的嗓音结果(感知和声学方面)和声襞功能(频闪喉镜检查)。选择50例患有喉部良性病变的成年患者,采用超脉冲模式、功率设置为6瓦进行二氧化碳激光切除。使用GRBAS评分进行感知分析。使用Praat软件进行嗓音分析,并评估基频、抖动、闪烁和谐波噪声比。进行频闪喉镜检查,以声门闭合和黏膜波模式为参数评估声襞功能。术前以及术后2周、6周和3个月对这些参数进行评估。感知分析显示术后GRBAS评分有显著改善(p < 0.001)。声学分析表明,术后所有参数均有显著改善(p < 0.001)。频闪喉镜检查显示,98%的患者声襞功能在声门闭合完整性以及规则、周期性黏膜波方面有所改善。超脉冲微光斑二氧化碳激光是治疗声带良性病变的一种安全有效的选择,嗓音结果良好。