Nacci A, Romeo S O, Berrettini S, Matteucci J, Cavaliere M D, Mancini V, Panicucci E, Ursino F, Fattori B
ENT Audiology Phoniatrics Unit, Department of Neurosciences, University of Pisa, Italy.
Division of ENT Diseases, Karolinska Institutet, Stockholm, Sweden.
Acta Otorhinolaryngol Ital. 2017 Aug;37(4):286-294. doi: 10.14639/0392-100X-1035.
The purpose of this study is to understand if there is any alteration in the posture of patients affected by organic dysphonia and describe possible postural modifications after phonomicrosurgery on the vocal folds. Forty subjects (22 males, 18 females; mean age 32.6 ± 7.5 years) suffering from organic dysphonia (15 cases of polyps, 11 submucosal retention cysts, 10 bilateral fibrous vocal fold nodules and 4 bilateral Reinke's oedema) were examined by open-eye and closed-eye posturography while breathing spontaneously before surgery, 24 hours after surgery and after 6 months. The variables taken into account were: the coordinates of the centre of pressure on both frontal and sagittal planes, length and surface of the track, mean velocity of the oscillations and relative standard deviations, spectral analysis of oscillation frequency, statokinesigram and stabilogram values. No characteristic pathological pattern was seen in basal stabilometry in any of the subgroups (polyps, cysts, Reinke's oedema). Only the subgroup of patients with fibrous vocal fold nodules (8/10; 80%) showed a slight forward shift from the centre of gravity when analysed in both open-eye and closed-eye posturography. A comparison performed within the same subgroup using open-eye and closed-eye posturography before and after surgery revealed no significant difference in any of the parameters being studied. The use of static stabilometry in this study demonstrates the absence of characteristic postural alterations in patients affected by organic dysphonia and also excludes that simple removal of the vocal fold lesion can change posture.
本研究的目的是了解有机性发声障碍患者的姿势是否有任何改变，并描述声带显微手术后可能出现的姿势改变。对40名患有有机性发声障碍的受试者（22名男性，18名女性；平均年龄32.6±7.5岁）进行了研究，其中包括15例息肉、11例黏膜下潴留囊肿、10例双侧纤维性声带结节和4例双侧任克氏水肿。在手术前、术后24小时和6个月后，让受试者在自然呼吸状态下，分别通过睁眼和闭眼姿势描记法进行检查。所考虑的变量包括：额面和矢状面上压力中心的坐标、轨迹的长度和面积、振荡的平均速度和相对标准差、振荡频率的频谱分析、静态运动图和稳定图值。在任何亚组（息肉、囊肿、任克氏水肿）的基础稳定测量中均未发现特征性病理模式。只有纤维性声带结节患者亚组（8/10；80%）在睁眼和闭眼姿势描记法分析时，重心有轻微向前移动。在同一亚组内，对手术前后的睁眼和闭眼姿势描记法进行比较，结果显示所研究的任何参数均无显著差异。本研究中使用静态稳定测量法表明，有机性发声障碍患者不存在特征性姿势改变，同时也排除了单纯切除声带病变会改变姿势的可能性。
