Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi.
Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan.
Otolaryngol Head Neck Surg. 2022 Feb;166(2):343-349. doi: 10.1177/01945998211015174. Epub 2021 Jun 1.
To examine the association of laryngoplasty, voice therapy, and pneumonia rate in patients with unilateral vocal fold paralysis (UVFP).
Population-based retrospective cohort study.
Data were collected from the LHID2000 (Longitudinal Health Insurance Database 2000), containing the information of 1 million randomly selected patients in Taiwan.
In the LHID2000, we identified 439 patients having new diagnoses of UVFP from 1997 to 2013. We grouped the aforementioned patients according to UVFP treatment and probed the occurrence of pneumonia: 305 patients underwent laryngoplasty or voice therapy, and 134 patients did not undergo treatment. Follow-up procedures were executed for the enrollees until death or December 31, 2013, representing the end of the study period. We assessed the association of UVFP treatment and pneumonia by executing Cox proportional hazards regression.
The pneumonia cumulative incidence was significantly higher among enrolled patients without treatment than in those receiving treatment ( < .001). The pneumonia incidence was significantly lower in patients receiving UVFP treatment (hazard ratio, 0.49; 95% CI, 0.27-0.88; = .018), as validated by the Cox proportional hazards model after adjustment. Patients undergoing laryngoplasty with or without voice therapy had a significantly lower incidence of pneumonia at 6 months and 1, 3, and 5 years, whereas those undergoing voice therapy alone did not.
Laryngoplasty was associated with a lower incidence of short- and long-term pneumonia in patients with UVFP. Physicians should encourage patients with UVFP at risk of aspiration to receive prompt evaluation as well as treatment.
探讨单侧声带麻痹（UVFP）患者行喉成形术、嗓音治疗与肺炎发生率的关系。
基于人群的回顾性队列研究。
数据来自 LHID2000（2000 年纵向健康保险数据库），包含台湾 100 万随机患者的信息。
在 LHID2000 中，我们鉴定了 1997 年至 2013 年间新发单侧声带麻痹的 439 名患者。我们根据 UVFP 治疗方法将上述患者进行分组，并探讨肺炎的发生情况：305 名患者行喉成形术或嗓音治疗，134 名患者未接受治疗。对参保者进行随访，直至死亡或 2013 年 12 月 31 日，即研究结束。我们通过 Cox 比例风险回归评估 UVFP 治疗与肺炎的相关性。
未治疗组的肺炎累积发生率明显高于治疗组（ <.001）。校正后的 Cox 比例风险模型显示，接受 UVFP 治疗的患者肺炎发生率明显降低（风险比，0.49；95%可信区间，0.27-0.88； =.018）。接受喉成形术联合或不联合嗓音治疗的患者在 6 个月、1、3 和 5 年时肺炎发生率显著降低，而仅接受嗓音治疗的患者则没有。
喉成形术可降低单侧声带麻痹患者短期和长期肺炎的发生率。对于有吸入性肺炎风险的单侧声带麻痹患者，医生应鼓励其及时接受评估和治疗。
