Kosztyła-Hojna Bożena, Łuczaj Jarosław, Berger Greta, Duchnowska Emilia, Zdrojkowski Maciej, Łobaczuk-Sitnik Anna, Biszewska Jolanta
Zakład Fonoaudiologii Klinicznej i Logopedii, Uniwersytet Medyczny w Białymstoku.
Klinika Otolaryngologii, Uniwersytet Medyczny w Białymstoku.
Otolaryngol Pol. 2019 Oct 11;74(2):31-35. doi: 10.5604/01.3001.0013.5260.
CO2 laser endoscopic cordectomy is the method of laryngeal cancer treatment. The type of cordectomy (I-VI) depends on the extent of the tumor. Endoscopic laser surgery provides more satisfactory phonation conditions in comparison to open surgical procedures.
The aim of the study was to classify phonatory compensation mechanisms after CO2 laser cordectomy using the HSDI. M aterial and methods: The study included 30 men treated and diagnosed at the Department of Otolaryngology and Department of Clinical Phonoaudiology and Logopedics, Medical University of Bialystok. The control included 30 men with no pathological changes in the larynx. Type III, IV and Va CO2 laser cordectomy have been for glottis cancer treatment. Postoperative evaluation has been conducted 6 months after the surgery. HSDI has been used in larynx visualization. R esults: Type I compensation occurs most frequently in patients after type III cordectomy. Advanced glottis cancer, as an indication for type IV and V cordectomy, leads to epiglottic hyperfunction and phonation involving vestibular folds - type II and III compensation. Type IV compensation is most frequent in type IV cordectomy. C onclusions: The type compensation is connected with the extent of glottis resection. In cordectomy including anterior commissure and the part of opposite fold (type Va), supraglottic hyperfunction with the participation of vestibular folds (type II and III compensation) has been recorded. Transmuscular cordectomy (type III) most often resulted in type I compensation. Type III-Va cordectomy caused reduction or absence of MW, decrease in amplitude and aperiodicity of vibrations in HSDI.
二氧化碳激光内镜下声带切除术是喉癌的治疗方法。声带切除术的类型(I - VI型)取决于肿瘤的范围。与开放性手术相比,内镜激光手术能提供更令人满意的发声条件。
本研究的目的是使用高速数字成像(HSDI)对二氧化碳激光声带切除术后的发声代偿机制进行分类。
该研究纳入了30名在比亚韦斯托克医科大学耳鼻喉科、临床语音听力学与言语治疗科接受治疗和诊断的男性。对照组包括30名喉部无病理变化的男性。III型、IV型和Va型二氧化碳激光声带切除术用于声门癌的治疗。术后6个月进行评估。使用HSDI对喉部进行可视化检查。
III型声带切除术后患者最常出现I型代偿。晚期声门癌作为IV型和V型声带切除术的指征,会导致会厌功能亢进以及涉及前庭襞的发声——II型和III型代偿。IV型代偿在IV型声带切除术中最为常见。
代偿类型与声门切除范围有关。在包括前联合和对侧襞部分(Va型)的声带切除术中,记录到了前庭襞参与的声门上功能亢进(II型和III型代偿)。经肌肉声带切除术(III型)最常导致I型代偿。III型至Va型声带切除术导致平均发声频率降低或消失、振幅减小以及HSDI中振动的非周期性变化。