Youssef Gamal, Mahboub Bassam-Hasan, Azab Safinaz-Nagib
Department of Otolaryngology, Faculty of Medicine, Alexandria University, Egypt and Consultant Phoniatrics, ENT Department, Dubai Hospital, DHA, Dubai, UAE.
Consultant and Head of Pulmonology Unit, Dubai Hospital, DHA, Dubai, UAE.
Iran J Otorhinolaryngol. 2021 Mar;33(115):97-102. doi: 10.22038/ijorl.2020.47194.2550.
Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx. The aim of the present work was to study the laryngostroboscopic features and voice quality of patients with laryngeal TB secondary to pulmonary TB.
Participants were 35 patients diagnosed as having pulmonary TB and dysphonia. All patients had a complete history, clinical and laboratory workup. Patients were assessed using a protocol of voice assessment which included Auditory-perceptual analysis of voice, voice analysis using the Multidimensional Voice Profile (MDVP), and laryngostroboscopy.
The participants were 24 males and 11 females and their mean age was 43.7 years. The voice acoustic analysis revealed a significant difference from normal in jitter percent, shimmer percent, and harmonic to noise (H/N) ratio. Laryngeal gross lesions were found in 11 patients while the other 24 patients had normal laryngoscopic findings with nonspecific stroboscopic changes as reduced mucosal waves and mild glottic gap. Diffuse lesion of the whole vocal folds was found in 5 patients and anterior predilection in 4 patients. The type of lesions were granulomatous lesions in 7 patients and non-specific inflammatory mild exophytic lesions in 4 patients.
Voice disorders in pulmonary TB include disturbance in the mechanism of voice production with or without detectable laryngeal lesion. Videostroboscopy has the advantage of showing the extension of laryngeal involvement, vocal folds vibrations, and mucosal waves.
喉结核（LTB）是喉部最常见的肉芽肿性疾病。本研究的目的是探讨肺结核继发喉结核患者的喉动态镜特征及嗓音质量。
研究对象为35例诊断为肺结核并伴有发音障碍的患者。所有患者均有完整的病史、临床及实验室检查。采用包括嗓音听觉感知分析、多维嗓音分析（MDVP）及喉动态镜检查在内的嗓音评估方案对患者进行评估。
参与者中男性24例，女性11例，平均年龄43.7岁。嗓音声学分析显示，其抖动百分比、闪烁百分比及谐波噪声比（H/N）与正常情况有显著差异。11例患者发现喉部有明显病变，另外24例患者喉镜检查结果正常，但动态镜检查有非特异性改变，如黏膜波减弱和声门间隙轻度增宽。5例患者声带呈弥漫性病变，4例患者病变靠前。病变类型中，7例为肉芽肿性病变，4例为非特异性炎症性轻度外生性病变。
肺结核患者的嗓音障碍包括发声机制紊乱，可伴有或不伴有可检测到的喉部病变。视频动态镜检查的优势在于可显示喉部受累范围、声带振动及黏膜波情况。
