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内镜鼻窦手术对慢性鼻窦炎患者嗓音特征的影响。

The Effects of Endoscopic Sinus Surgery on Voice Characteristics in Chronic Rhinosinusitis Patients.

作者信息

Jandali Danny B, Ganti Ashwin, Husain Inna A, Batra Pete S, Tajudeen Bobby A

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Rush Sinus Program, Rush University Medical Center, Chicago, IL, USA.

Rush Medical College, Chicago, IL, USA.

出版信息

Ann Otol Rhinol Laryngol. 2019 Dec;128(12):1129-1133. doi: 10.1177/0003489419861124. Epub 2019 Jul 17.

Abstract

OBJECTIVES

Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed.

METHODS

Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms.

RESULTS

18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, = .005) and VHI (10-4.7, < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, < .001).

CONCLUSIONS

Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.

摘要

目的

功能性内镜鼻窦手术(FESS)是慢性鼻窦炎(CRS)患者经适当药物治疗失败后的标准治疗方式。然而,FESS需要对上呼吸道进行改造,这可能会改变发声共鸣并导致声音变化。FESS对CRS患者术后声音特征的影响尚未得到定量评估。

方法

前瞻性纳入2017年5月至10月在三级医疗转诊中心接受FESS的重度CRS患者。采用嗓音听觉感知评估共识(CAPE-V)和嗓音障碍指数(VHI)分别定量评估声音特征和生活质量。将每位患者术前和术后的CAPE-V及VHI评分进行比较。还获取了鼻窦结局测试(SNOT-22)评分以评估患者症状的变化。

结果

纳入18例接受FESS的CRS患者。术前平均Lund-Mackay评分为14分,表明基线为重度CRS。术后评估显示CAPE-V评分(45 - 27,P = .005)和VHI评分(10 - 4.7,P < .001)有统计学意义的下降。这些与SNOT-22评分的统计学显著下降(42 - 13,P < .001)相关。

结论

CRS患者在FESS术后声音特征和嗓音生活质量有显著改善。此外,这似乎与自我报告的疾病严重程度显著降低相关。这些发现可能会将对FESS潜在益处的讨论扩展到嗓音质量的新潜在领域。

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