Huang Hsin-Hsin, Tsao Chien-Han, Wei James Cheng-Chung
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan.
Front Surg. 2021 Mar 17;8:647792. doi: 10.3389/fsurg.2021.647792. eCollection 2021.
Removal of part of the tongue base, in combination with uvulopharyngopalatoplasty via transoral robotic surgery (TORS), for treating obstructive sleep apnea syndrome (OSAS) results in enlargement of the oropharynx and hypopharynx and change in the size of the resonance chamber. These procedures may also alter the laryngeal-hyoid bone complex, which is linked to vocal fold tension. Thus, there is the potential for change in phonation and pitch after surgery. Prospective, nonrandomized, institutional board-approved study. From January to August 2018, 15 patients with OSAS receiving TORS underwent voice and pitch sampling. The multi-dimensional voice program (MDVP) was applied to the evaluation of preoperative sound parameters. Highest pitch and lowest pitch were obtained with real-time pitch software, with pitch synchronized to electronic organ or tuner. Subjects also completed the Voice Handicap Index-10 scale (VHI-10), to assess their subjective perception and to detect factors affecting the VHI-10 score. The relevant parameters were analyzed again 3 months after the operation. There was an increase in VHI-10 score 3 months after operation that did not reach statistical significance. There were also no significant differences in sound parameters. Increases in highest pitch (353.18 Hz shift to 387.99 Hz), highest semitone ( shift to ), lowest pitch (117.45 Hz shift to 131.42 Hz), and lowest semitone (C shift to C) did not reach statistical significance. The increase in the lowest semitone was significantly related to change in VHI-10 score ( = -0.808, = 0.028). Patients with OSA undergoing TORS showed a negative correlation coefficient over 0.8 with change in VHI-10 score. That is, increase in the lowest semitone after operation correlated with increase in VHI-10 score which may cause perceive changes in subjective pronunciation.
通过经口机器人手术（TORS）切除部分舌根并联合悬雍垂腭咽成形术治疗阻塞性睡眠呼吸暂停综合征（OSAS），会导致口咽和下咽扩大以及共鸣腔大小改变。这些手术还可能改变与声带张力相关的喉-舌骨复合体。因此，术后存在发声和音高改变的可能性。前瞻性、非随机、经机构审查委员会批准的研究。2018年1月至8月，15例接受TORS治疗的OSAS患者接受了声音和音高采样。采用多维度嗓音程序（MDVP）评估术前声音参数。使用实时音高软件获取最高音高和最低音高，音高与电子琴或调音器同步。受试者还完成了嗓音障碍指数-10量表（VHI-10），以评估他们的主观感受并检测影响VHI-10评分的因素。术后3个月再次分析相关参数。术后3个月VHI-10评分升高，但未达到统计学意义。声音参数也无显著差异。最高音高（从353.18 Hz变为387.99 Hz）、最高半音（变为）、最低音高（从117.45 Hz变为131.42 Hz）和最低半音（从C变为C）的升高均未达到统计学意义。最低半音的升高与VHI-10评分的变化显著相关（=-0.808，=0.028）。接受TORS治疗的OSAS患者与VHI-10评分变化的相关系数超过0.8。也就是说，术后最低半音的升高与VHI-10评分的升高相关，这可能导致主观发音出现可感知的变化。
