Department of Otolaryngology - Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
Department of Otolaryngology - Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
J Voice. 2020 Jul;34(4):649.e1-649.e6. doi: 10.1016/j.jvoice.2018.12.012. Epub 2019 Jan 5.
This study was performed to evaluate the characteristics of the Voice Handicap Index (VHI), a self-assessment measure, for patients with unilateral vocal fold paralysis (UVFP) who underwent arytenoid adduction (AA), in comparison with postoperative vocal function examinations.
A retrospective chart review was conducted for patients who underwent AA at Tohoku University Hospital during the period between 2014 and 2017. VHI was compared before and after surgery; moreover, correlations were assessed between the VHI and other voice measurements, including perceptual assessment of voice, as well as aerodynamic and acoustic measures. Factors involved in the VHI score were explored by multivariate analysis.
Forty-three UVFP patients (28 males, age 32-81 years; 15 females, age 34-80 years) were enrolled in the study; the average age of all patients was 61.5 years (32-81 years). Among the enrolled patients, 33 (76.7%) left and 10 (23.3%) right vocal folds were impaired. After surgery, nearly all of the patients exhibited significantly improved VHI score; each of the three subscales (functional, physical, and emotional) was also improved. The postoperative VHI correlated mildly with several values of the other voice measurements, with the exception of the mean flow rate. Multivariate analysis showed that the sole variable associated with postoperative VHI score was preoperative VHI.
The postoperative VHI likely reflects improvement in the voices of the patients with UVFP. Although there were weak correlations with other voice measures, postoperative VHI is a relatively independent measurement parameter for patients with UVFP who underwent AA.
本研究旨在评估嗓音障碍指数（VHI）作为一种自我评估工具，在单侧声带麻痹（UVFP）患者接受杓状软骨内收术（AA）后，与术后嗓音功能检查相比的特点。
回顾性分析了 2014 年至 2017 年在东北大学医院接受 AA 的患者的病历。比较了手术前后的 VHI；此外，还评估了 VHI 与其他嗓音测量值之间的相关性，包括嗓音的听觉评估，以及空气动力学和声学测量值。通过多元分析探讨了 VHI 评分的相关因素。
本研究共纳入 43 例 UVFP 患者（28 名男性，年龄 32-81 岁；15 名女性，年龄 34-80 岁）；所有患者的平均年龄为 61.5 岁（32-81 岁）。纳入的患者中，33 例（76.7%）左侧声带受损，10 例（23.3%）右侧声带受损。手术后，几乎所有患者的 VHI 评分都显著提高；三个子量表（功能、生理和情感）也都得到了改善。术后 VHI 与其他嗓音测量值的多个值呈轻度相关，除平均流量率外。多元分析表明，与术后 VHI 评分相关的唯一变量是术前 VHI。
术后 VHI 可能反映了 UVFP 患者嗓音的改善。尽管与其他嗓音测量值的相关性较弱，但术后 VHI 是接受 AA 的 UVFP 患者相对独立的测量参数。
