Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida.
Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic in Florida, Jacksonville, Florida.
J Voice. 2024 Mar;38(2):472-478. doi: 10.1016/j.jvoice.2021.09.013. Epub 2021 Nov 2.
The presence of a vocal fold mass implies high mechanical stress at the vocal fold base during vibration and an impaired glottic closure. However, evidence about its potential effects on diagnostic tools used in voice evaluation is lacking. We aimed to evaluate the impact of the location, laterality, and size of a unilateral unique vocal fold lesion on patient self-assessment questionnaires, acoustic-aerodynamic voice measures, and perceptual voice evaluation (GRBAS scale).
A retrospective chart review involving patients with a diagnosis of a unique unilateral vocal fold lesion and a complete voice evaluation was performed. A total of 58 patients were enrolled and demographics, characteristics of the vocal fold lesion (size, laterality, and location), self-assessment questionnaires, acoustic-aerodynamic measures, and perceptual evaluation (GRBAS scale) were analyzed. Pearson correlation and ANOVA analysis were completed to evaluate the correlation between the clinical characteristics of the vocal fold mass and self-assessment questionnaires, and to compare the level of significance for the differences between the continuous variables between groups of patients once stratified according to the location or laterality of the vocal fold mass.
Glottal Function Index was found to correlate with the location of the vocal fold mass (P < 0.05), however, no correlation was found when evaluating the Reflux Symptom Index or the Voice Handicap Index (P > 0.05). Patients with a lesion located in the anterior-middle 2/3 of the vocal fold were found to have a higher mean Glottal Function Index and (G) component of the GRBAS scale (P < 0.05). No differences were observed when analyzing the remaining self-assessment questionnaires or the acoustic-aerodynamic voice measures according to size, location, or laterality of the vocal fold lesion (P > 0.05).
The size and location of unilateral vocal fold lesions were found to have no effect on the majority of measures analyzed in this study. This is the first study we know of to assess the effect that laterality of the vocal fold lesion may have on the self-assessment questionnaires, audio-perceptual, and acoustic-aerodynamic measures included in this study. Our study found no significant differences in regard to laterality. This may indicate that other factors (eg, stiffness of lesion, amount of extraneous muscle tension, etc) could have more of an impact on audio-perceptual, self-assessment questionnaires, and acoustic-aerodynamic measures. Further research with larger cohort sizes and possibly prospective analysis is needed.
声带息肉的存在意味着在振动过程中声带基底处存在较高的机械应力，并且声门关闭受损。然而，目前尚无关于其对嗓音评估中使用的诊断工具的潜在影响的证据。我们旨在评估单侧独特声带病变的位置、侧别和大小对患者自我评估问卷、声学-空气动力学嗓音测量和感知嗓音评估（GRBAS 量表）的影响。
对诊断为单侧独特声带病变且完成完整嗓音评估的患者进行回顾性图表审查。共纳入 58 例患者，分析其人口统计学资料、声带病变特征（大小、侧别和位置）、自我评估问卷、声学-空气动力学测量和感知评估（GRBAS 量表）。完成 Pearson 相关性分析和 ANOVA 分析，以评估声带息肉的临床特征与自我评估问卷之间的相关性，并根据声带息肉的位置或侧别对患者进行分层后，比较各组间连续变量的差异水平的显著性。
发现声门功能指数与声带息肉的位置相关（P < 0.05），但在评估反流症状指数或嗓音障碍指数时未发现相关性（P > 0.05）。声带息肉位于声带前中 2/3 处的患者，声门功能指数和 GRBAS 量表的（G）分量更高（P < 0.05）。根据声带病变的大小、位置或侧别，对其余自我评估问卷或声学-空气动力学嗓音测量指标进行分析时，未观察到差异（P > 0.05）。
本研究发现单侧声带病变的大小和位置对本研究分析的大多数测量指标均无影响。这是我们所知的第一项评估声带病变侧别对本研究纳入的自我评估问卷、音频感知和声学-空气动力学测量指标影响的研究。我们的研究未发现侧别方面的显著差异。这可能表明其他因素（例如，病变的僵硬程度、多余肌肉张力的量等）可能对音频感知、自我评估问卷和声学-空气动力学测量指标有更大的影响。需要进一步开展更大样本量的研究和可能的前瞻性分析。
