Pan Xiaofei, Wang Jun, Xiao Yang
Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100730,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb;34(2):162-165. doi: 10.13201/j.issn.1001-1781.2020.02.015.
The aim of this study is to investigate the effect of CO2 laser cordectomy on the voice of early glottic carcinoma. A retrospective analysis of 40 patients who underwent CO2 laser treatment early glottis preoperative clinical data of postoperative laryngeal cancer patients, patients with postoperative recurrence rate, survival rate, and the postoperative complications of patients with preoperative and postoperative laryngoscopy, voice disorders index(voice handicap index, VHI) simplified Chinese version(VHI 13) rating scale, affecting the stability sound quality postoperatively in patients with laryngeal cancer were discussed. All patients underwent voice reexamination 8-97 months after surgery, and the survival rate was 100%, no local recurrence and no obvious postoperative complications. Compared with the healthy control group, there were statistically significant differences in the four indicators F0(fundamental frequency), Jitter(fundamental frequency perturbation), Shimmer(amplitude perturbation) and MPT(maximum pronunciation time), suggesting that CO2 laser surgery resulted in significant changes in acoustic parameters. Jitter and Shimmer indexes in the pre involved combined group were statistically significant different from those in the non involved combined group, suggesting that the sound quality of the pre involved combined group was worse in the postoperative stability period. The VHI score indicated that most patients with early glottic cancer were in severe voice disorder before operation and most were in moderate voice disorder after operation. Compared with the healthy control group, the VHI score and total score of the healthy control group were lower in terms of physiology, psychology and emotion. Compared with the healthy control group, the VHI score and physiology of the early glottic laryngeal cancer patients were lower in the early glottic laryngeal cancer patients before and after surgery, and they were statistically significant. CO2 laser surgery for early glottic cancer, the overall survival rate of patients, low recurrence rate, fewer complications, CO2 laser surgery led to significant changes in acoustic parameters, postoperative sound quality and whether the involvement of pre-associated factors; The total score of VHI and physiological score of early glottic carcinoma patients after CO2 laser operation were better than those before operation.
本研究旨在探讨CO₂激光声带切除术对早期声门癌患者嗓音的影响。回顾性分析40例行CO₂激光治疗的早期声门癌患者术前临床资料、术后喉癌患者复发率、生存率、术前术后并发症情况以及术前术后喉镜检查、嗓音障碍指数(嗓音障碍指数,VHI)中文版(VHI 13)评分量表,探讨影响喉癌患者术后嗓音质量稳定性的因素。所有患者术后8 - 97个月进行嗓音复查,生存率为100%,无局部复发,术后无明显并发症。与健康对照组相比,F0(基频)、Jitter(基频微扰)、Shimmer(幅度微扰)和MPT(最大发声时间)这四项指标差异有统计学意义,提示CO₂激光手术导致声学参数发生显著变化。术前累及联合组的Jitter和Shimmer指数与未累及联合组相比差异有统计学意义,提示术前累及联合组术后嗓音质量在稳定期较差。VHI评分显示,大多数早期声门癌患者术前存在重度嗓音障碍,术后多为中度嗓音障碍。与健康对照组相比,早期声门癌患者在生理、心理和情感方面的VHI评分及总分均低于健康对照组。与健康对照组相比,早期声门癌患者手术前后的VHI评分及生理指标均较低,差异有统计学意义。CO₂激光手术治疗早期声门癌,患者总体生存率高、复发率低、并发症少,CO₂激光手术导致声学参数发生显著变化,术后嗓音质量与术前是否累及相关因素有关;CO₂激光手术后早期声门癌患者的VHI总分及生理评分均优于术前。