Department of Otolaryngology-Head and Neck Surgery, 159395Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai, People's Republic of China.
Ear Nose Throat J. 2021 Feb;100(1_suppl):87S-93S. doi: 10.1177/0145561320946153. Epub 2020 Aug 10.
We retrospectively analyzed the laryngoscopy results and voice outcomes of patients with vocal polyps who received potassium titanyl phosphate (KTP) laser treatments in a clinician's office, in order to establish the effectiveness and relative factors affecting the efficacy of this treatment.
We enrolled 25 patients with vocal polyps who had undergone KTP laser treatment in the Department of Otorhinolaryngology at our hospital between July 2017 and November 2019. Pre- and postoperative evaluations were measured using laryngovideostroboscopy (LVS), the Voice Handicap Index questionnaire (VHI-30), the GRBAS scale (G hoarseness, R roughness, B breathiness, A asthenia, S strain), and objective acoustic parameters. The reduction rate of lesions was calculated and relative factors affecting efficacy (size, side, location, the position of lesions, type, gender, and occupation) were tested.
Areas of lesions decreased from 101.95 ± 70.16 before surgery to 30.49 ± 35.80 after surgery ( = 5.234, < .001). The LVS data showed that the postoperative proportions of normal to mild conditions were the same or higher than the preoperative data in 3 instances: glottal closure (100% vs 100%), amplitude (90.91% vs 63.64%), and mucosal wave (81.82% vs 54.55%). A significant improvement was observed in VHI-30 scores, GRBAS scores, and acoustic parameters ( < .05). The size of lesions had an effect on the GRBAS scores ( < .001) but not on VHI-30 scores and objective acoustic parameters ( > .05). Other factors we tested did not affect voice outcomes.
Potassium titanyl phosphate laser treatment can effectively reduce the lesion area of vocal polyps and improve the voice quality. The presence of small lesions seems to predict good subjective assessments of voice quality, but it remains to be seen whether this correlates with true voice quality.
我们回顾性分析了在临床医生办公室接受 KTP 激光治疗的声带息肉患者的喉镜结果和嗓音结果，以确定该治疗的有效性及其影响疗效的相关因素。
我们招募了 2017 年 7 月至 2019 年 11 月期间在我院耳鼻喉科接受 KTP 激光治疗的 25 名声带息肉患者。采用喉视频频闪喉镜（LVS）、嗓音障碍指数问卷（VHI-30）、GRBAS 量表（G 粗糙，R 粗糙，B 气息，A 无力，S 紧张）和客观声学参数对术前和术后进行评估。计算病变的减少率，并测试影响疗效的相关因素（大小、侧别、位置、病变位置、类型、性别和职业）。
病变面积从术前的 101.95 ± 70.16 减少到术后的 30.49 ± 35.80（ = 5.234， <.001）。LVS 数据显示，术后声带闭合、振幅和黏膜波的正常或轻度比例与术前相同或高于术前，分别为 100%比 100%、90.91%比 63.64%和 81.82%比 54.55%。VHI-30 评分、GRBAS 评分和声学参数均有显著改善（ <.05）。病变大小对 GRBAS 评分有影响（ <.001），但对 VHI-30 评分和客观声学参数无影响（ >.05）。我们测试的其他因素对嗓音结果没有影响。
KTP 激光治疗可有效缩小声带息肉的病变面积，改善嗓音质量。小病变的存在似乎预示着主观嗓音质量评估良好，但这是否与真实的嗓音质量相关还有待观察。
