Hsu Cheng-Ming, Yang Ming-Yu, Fang Tuan-Jen, Wu Ching-Yuan, Tsai Yao-Te, Chang Geng-He, Tsai Ming-Shao
Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Healthcare (Basel). 2020 Sep 7;8(3):326. doi: 10.3390/healthcare8030326.
: Vocal fold nodules (VFNs) are a challenge for otolaryngologists. Glottal area (GA) waveform analysis is an examination method used for assessing vocal fold vibration and function. However, GA in patients with VFNs has rarely been studied. This study investigated the maximum and minimum GA in VFN patients using modern waveform analysis combining ImageJ software and videostroboscopy. : This study enrolled 42 patients newly diagnosed with VFN, 15 of whom received voice therapy and 27 of whom underwent surgery. Acoustic parameters and maximum phonation time (MPT) were recorded, and patients completed the Chinese Voice Handicap Index-10 (VHI-C10) before and after treatment. After videostroboscopy examination, the maximum and minimum GAs were calculated using ImageJ software. The GAs of patients with VFNs before and after surgery or voice therapy were analyzed. : The MPTs of the patients before and after voice therapy or surgery did not change significantly. VHI-C10 scores decreased after voice therapy but the decrease was nonsignificant (14.0 ± 8.44 vs. 9.40 ± 10.24, = 0.222); VHI-C10 scores were significantly decreased after surgery (22.53 ± 7.17 vs. 12.75 ± 9.84, = 0.038). Voice therapy significantly increased the maximum GA (5.58 ± 2.41 vs. 8.65 ± 3.17, = 0.012) and nonsignificantly decreased the minimum GA (0.60 ± 0.73 vs. 0.21 ± 0.46, = 0.098). Surgery nonsignificantly increased the maximum GA (6.34 ± 3.82 vs. 8.73 ± 5.57, p = 0.118) and significantly decreased the minimum GA (0.30 ± 0.59 vs. 0.00 ± 0.00, = 0.036). This study investigated the GA of patients with VFNs who received voice therapy or surgery. The findings indicated that voice therapy significantly increased maximum GA and surgery significantly decreased minimum GA. GA analysis could be applied to evaluate the efficacy of voice therapy, and it may help physicians to develop precise treatment for VFN patients (either by optimizing voice therapy or by performing surgery directly).
声带小结（VFNs）对耳鼻喉科医生来说是一项挑战。声门面积（GA）波形分析是一种用于评估声带振动和功能的检查方法。然而，很少有研究关注VFN患者的GA情况。本研究使用结合ImageJ软件和视频频闪喉镜的现代波形分析方法，对VFN患者的最大和最小GA进行了研究。
本研究纳入了42例新诊断为VFN的患者，其中15例接受了嗓音治疗，27例接受了手术。记录声学参数和最长发声时间（MPT），患者在治疗前后完成中文版嗓音障碍指数-10（VHI-C10）。在视频频闪喉镜检查后，使用ImageJ软件计算最大和最小GA。分析了VFN患者手术或嗓音治疗前后的GA情况。
嗓音治疗或手术后患者的MPT没有显著变化。嗓音治疗后VHI-C10评分有所下降，但下降不显著（14.0±8.44 vs. 9.40±10.24，P = 0.222）；手术后VHI-C10评分显著下降（22.53±7.17 vs. 12.75±9.84，P = 0.038）。嗓音治疗显著增加了最大GA（5.58±2.41 vs. 8.65±3.17，P = 0.012），最小GA有非显著下降（0.60±0.73 vs. 0.21±0.46，P = 0.098）。手术使最大GA有非显著增加（6.34±3.82 vs. 8.73±5.57，P = 0.118），最小GA显著下降（0.30±0.59 vs. 0.00±0.00，P = 0.036）。
本研究对接受嗓音治疗或手术的VFN患者的GA进行了研究。结果表明，嗓音治疗显著增加了最大GA，手术显著降低了最小GA。GA分析可用于评估嗓音治疗的效果，可能有助于医生为VFN患者制定精准治疗方案（通过优化嗓音治疗或直接进行手术）。
