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小儿腺样体扁桃体切除术后的嗓音变化:误解还是事实?——一项初步研究

Voice Change Following Adenotonsillectomy in Pediatric Population: Myth or Reality?-A Pilot Study.

作者信息

Inja Ranjeetha Racheal, Paul Roshna Rose, Varghese Lalee, Santosh Swapna, Sebastian Tunny, Mathews Suma Susan

机构信息

Department of ENT, Christian Medical College, Vellore, Tamil Nadu India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):574-579. doi: 10.1007/s12070-018-1412-6. Epub 2018 Jun 4.

Abstract

Modifications in the structure of pharynx following adenotonsillectomy are presumed to cause changes in the voice characteristics of patients. Data on effect of tonsillectomy/adenotonsillectomy on changes in voice among Indian children are sparse. This study was thus conducted to study the effect of adenotonsillectomy/tonsillectomy on childrens' voice. It was a prospective observational study of children aged 4-15 years undergoing tonsillectomy with or without adenoidectomy. Measures of voice were noted preoperatively, 1 and 3 months post-operatively. Subjective evaluation was done using Paediatric Voice Outcome Survey (PVOS) questionnaire administered to participants' parents. Objective evaluation was done by recording and analyzing using PRAAT voice analysis software which is an open-software tool. Statistical analysis was done using the statistical software SPSS 17.0 version. There were 31 children between 4 and 14 years of age 65% being male. Adenotonsillectomy was done in 83.5%. There was statistically significant difference in the subjective scores (PVOS) pre-operatively and 3 month postoperative score ( value = 0.001). However, there was no statistically significant difference between any other pre op and post op parameters. Though the only significant post tonsillectomy voice changes noted was subjective by parents 3 months later, it does raise concern whether this could be a reality and not a myth. Further studies with larger number of patients, including involving the subjective evaluation (PVOS) by another person in addition to patients' parent need to be undertaken to address this issue.

摘要

腺样体扁桃体切除术后咽部结构的改变被认为会导致患者声音特征的变化。关于扁桃体切除术/腺样体扁桃体切除术对印度儿童声音变化影响的数据很少。因此,本研究旨在探讨腺样体扁桃体切除术/扁桃体切除术对儿童声音的影响。这是一项对4至15岁接受扁桃体切除术(伴或不伴腺样体切除术)儿童的前瞻性观察研究。在术前、术后1个月和3个月记录声音指标。主观评估采用向参与者家长发放的儿科嗓音结果调查问卷(PVOS)进行。客观评估通过使用PRAAT语音分析软件进行记录和分析,该软件是一种开放软件工具。使用统计软件SPSS 17.0版本进行统计分析。共有31名4至14岁的儿童,其中65%为男性。83.5%的儿童接受了腺样体扁桃体切除术。术前主观评分(PVOS)与术后3个月评分之间存在统计学显著差异(P值=0.001)。然而,术前和术后的任何其他参数之间均无统计学显著差异。虽然扁桃体切除术后唯一显著的声音变化是3个月后家长主观感觉到的,但这确实引发了人们对这是否是现实而非误解的担忧。需要开展更多患者参与的进一步研究,包括除患者家长外由另一人进行主观评估(PVOS),以解决这一问题。

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