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腺样体切除术伴或不伴扁桃体切除术对儿童嗓音声学参数及听觉感知特征的影响。

The effects on the acoustic parameters and auditory-perceptive characteristics of voice in children submitted to adenoidectomy with or without tonsillectomy.

作者信息

Pinto Isabel, Firmino-Machado João, Castro Eugénia, Alves Sandra, Helena Diamantino, Condé Artur

机构信息

ENT Department, Vila Nova de Gaia/Espinho Hospital Center, Vila Nova de Gaia, Portugal.

EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.

出版信息

Int J Pediatr Otorhinolaryngol. 2019 Oct;125:51-55. doi: 10.1016/j.ijporl.2019.06.021. Epub 2019 Jun 21.

Abstract

OBJECTIVES

To analyse the possible changes on the acoustic parameters and auditory-perceptive characteristics of children's voice after adenoidectomy with or without tonsillectomy.

METHODS

Prospective cohort study of children aged 5-12 years at one month before surgery (t0) and one (t1), three (t3) and six (t6) months after adenoidectomy with or without tonsillectomy. On each assessment the acoustic parameters (fundamental frequency, jitter %, shimmer % and harmonics-to-noise ratio) and auditory-perceptive analysis (nasal resonance, loudness, pitch, GRBAS scale and maximum phonation time) were recorded.

RESULTS

A total of 51 children were considered for data analysis. Nasal resonance revealed a significant decrease in the number of cases with hyponasality, from 86.3% at t0 to 12.8% at t1 (p < 0.001), 2.3% at t3 (p < 0.001) and 2.8% at t6 (p < 0.001). This improvement was maintained during the late follow-up time with no significant difference on nasal resonance between t0 and t3 (p = 0.250) and t3 and t6 (p = 0.250). All children with alteration on the GRBAS scale before the procedure showed a normal voice quality after the surgery. Regarding the acoustic parameters none showed a significant change with the surgery.

CONCLUSIONS

The results suggest that adenoidectomy with or without tonsillectomy is a safe procedure concerning voice alterations and can improve voice quality and nasal resonance in a sustained manner.

摘要

目的

分析腺样体切除术联合或不联合扁桃体切除术对儿童嗓音声学参数及听觉感知特征的可能影响。

方法

对5-12岁儿童进行前瞻性队列研究,分别在手术前1个月(t0)以及腺样体切除术联合或不联合扁桃体切除术后1个月(t1)、3个月(t3)和6个月(t6)进行评估。每次评估时记录声学参数(基频、抖动率、闪烁率和谐噪比)和听觉感知分析(鼻音、响度、音高、GRBAS评分和最长发声时间)。

结果

共51名儿童纳入数据分析。鼻音方面,鼻通气不足病例数显著减少,从t0时的86.3%降至t1时的12.8%(p<0.001)、t3时的2.3%(p<0.001)和t6时的2.8%(p<0.001)。这种改善在后期随访中持续存在,t0与t3之间(p=0.250)以及t3与t6之间(p=0.250)的鼻音无显著差异。所有术前GRBAS评分异常的儿童术后嗓音质量均正常。关于声学参数,手术前后均未显示出显著变化。

结论

结果表明,腺样体切除术联合或不联合扁桃体切除术对于嗓音改变是一种安全的手术,并且可以持续改善嗓音质量和鼻音。

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