Desuter G, Zapater E, Van der Vorst S, Henrard S, van Lith-Bijl J T, van Benthem P P, Sjögren E V
Otolaryngology, Head & Neck Surgery Department, Voice & Swallowing Clinic, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Otolaryngology, Head & Neck Surgery Department, LUMC, University of Leiden, Leiden, The Netherlands.
Clin Otolaryngol. 2018 Aug;43(4):1097-1103. doi: 10.1111/coa.13113. Epub 2018 Apr 23.
The aim of this multicentric cross-sectional study was to examine the permanency of Montgomery thyroplasty (MTIS) results from a patient's perspective.
The study consisted of collecting Voice Handicap Index (VHI-30) questionnaires from patients who had previously been operated with MTIS between 2 and 12 years before. Very long-term (>2 years) postoperative data were compared with the previously acquired preoperative and early postoperative VHI results. Influence of factors such as age, gender, size/side of the prosthesis and length of the follow-up were also analysed.
Multicentric study involving three tertiary European voice centres.
Forty-nine unilateral vocal fold paralysis (UVFP) patients, treated by MTIS, were included in the study.
The Voice Handicap Index-30 score.
RESULTS & CONCLUSIONS: The median VHI was significantly different over time-points (Friedman's test P < .001), with a significant difference between preoperative and early postoperative time-points (median VHI: 70 vs 21, respectively; P < .001) and between preoperative and very long-term postoperative time-points (median VHI: 70 vs 16, respectively; P < .001). The median VHI did not differ for the early and very long-term postoperative time-points (median VHI: 21 vs 16; P = .470). Age differences, gender differences and size/side differences of the prostheses, centres where surgery took place and length of the follow-up showed no significant influence. Medialisation thyroplasty (MT) overall and MTIS, in particular, should be considered as a possible standard of care for UVFP when permanency of voice results is sought.
这项多中心横断面研究旨在从患者角度检验蒙哥马利甲状腺成形术（MTIS）的效果持久性。
该研究包括收集之前在2至12年前接受过MTIS手术患者的嗓音障碍指数（VHI-30）问卷。将长期（>2年）术后数据与之前获取的术前和早期术后VHI结果进行比较。还分析了年龄、性别、假体尺寸/侧别以及随访时间等因素的影响。
涉及三个欧洲三级嗓音中心的多中心研究。
49例接受MTIS治疗的单侧声带麻痹（UVFP）患者纳入研究。
嗓音障碍指数-30评分。
VHI中位数在各时间点有显著差异（Friedman检验P <.001），术前与早期术后时间点之间有显著差异（VHI中位数分别为70和21；P <.001），术前与长期术后时间点之间也有显著差异（VHI中位数分别为70和16；P <.001）。早期和长期术后时间点的VHI中位数无差异（VHI中位数分别为21和16；P =.470）。年龄差异、性别差异、假体尺寸/侧别差异、手术中心以及随访时间均未显示出显著影响。总体而言，尤其是MTIS，当追求嗓音效果持久性时，应将内侧化甲状腺成形术（MT）视为UVFP可能的治疗标准。
