Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, Australia.
The Canterbury Hospital, Department of Otolaryngology, Head and Neck Surgery, Campsie, Australia.
Laryngoscope. 2020 Apr;130(4):980-985. doi: 10.1002/lary.28205. Epub 2019 Jul 30.
This study examined the effectiveness of injection laryngoplasty (IL) in muscle tension dysphonia (MTD) patients who did not fully respond to voice therapy. It was hypothesized that IL would improve voice quality and voice-related quality of life measures in MTD.
A retrospective review was conducted on 37 patients with a primary diagnosis of MTD who underwent IL following a suboptimal response to voice therapy (mean age = 43.0 years; standard deviation [SD] = 13.4; range = 23 to 71). Outcome measures included laryngoscopic signs of supraglottic constriction, Voice Handicap Index-10 (VHI-10) scores, maximal phonation time, vowel fundamental frequency (F0), standard deviation of F0 (F0SD), harmonics-to-noise ratio (HNR), and smoothed cepstral peak prominence. These were compared between baseline and within 3 months following the IL procedure.
There was significant decrease in supraglottic constriction. Mean (SD) of VHI-10 scores decreased from 25.4 (5.7) at baseline to 15.3 (9.3) following IL. This improvement in VHI-10 was observed in patients with and without baseline glottal insufficiency (GI). Mean (SD) of HNR (decibels) increased from 21.1 (5.4) at baseline to 22.8 (4.3) after IL. Only patients with GI demonstrated a significant improvement in HNR from baseline to post-IL. No statistically significant differences in other acoustic measures were observed.
IL resulted in positive changes in voice-related quality of life in MTD patients with and without GI. Acoustically, only those with GI demonstrated an increase in HNR following IL. Further studies are needed to examine the effects of IL in MTD.
4 Laryngoscope, 130:980-985, 2020.
本研究旨在探讨注射性喉成形术（IL）对经语音治疗后反应不完全的肌张力障碍性发声障碍（MTD）患者的疗效。我们假设 IL 可以改善 MTD 患者的嗓音质量和嗓音相关生活质量评估指标。
对 37 例 MTD 患者进行回顾性研究，这些患者在接受语音治疗后反应不佳（平均年龄 43.0 岁，标准差 [SD] = 13.4，范围 23 至 71 岁），随后接受了 IL 治疗。评估指标包括：声门上收缩的喉镜征象、嗓音障碍指数-10 （VHI-10）评分、最大发音时间、基频（F0）、F0 标准差（F0SD）、谐噪比（HNR）和谱峰突出度。这些指标在 IL 治疗前和治疗后 3 个月内进行了比较。
声门上收缩显著减少。VHI-10 评分从基线时的 25.4（5.7）降至 IL 治疗后的 15.3（9.3），下降有统计学意义。在基线时存在或不存在声门闭合不全（GI）的患者中，VHI-10 评分均得到改善。HNR（分贝）从基线时的 21.1（5.4）增加到 IL 治疗后的 22.8（4.3），但仅在存在 GI 的患者中观察到 HNR 从基线到 IL 治疗后有显著改善。其他声学测量指标无统计学差异。
IL 可改善存在或不存在 GI 的 MTD 患者的嗓音相关生活质量。仅在存在 GI 的患者中，IL 治疗后 HNR 增加。需要进一步研究 IL 在 MTD 中的作用。
4 级喉镜，130：980-985，2020 年。
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