Drexel University College of Medicine.
Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine Philadelphia PA United States of America.
J Voice. 2024 Mar;38(2):510-515. doi: 10.1016/j.jvoice.2021.10.002. Epub 2021 Nov 28.
The purpose of the study was to examine gender-related differences in benign vocal fold mass treatment.
Adult patient with vocal fold mass diagnosed on strobovideolaryngoscopy examination were reviewed retrospectively. Patient demographics, past medical history, laboratory data, and examination findings during the initial visit and at follow-up were collected. The duration of voice therapy and the prevalence of surgery were analyzed for males and females.
One hundred and fifty-eight patients (76 male and 82 female) were included. The percentage of professional voice users differed significantly between males and females. Vocal folds of females had a higher percent of reactive masses present. Females were also more likely to have a pseudocyst. Vocal folds of males showed a higher percent of masses of unspecified category on strobovideolaryngoscopy examination. A significantly greater proportion of females had abnormal high shimmer values, and abnormal low maximum phonation time; and a significantly greater proportion of females compared to males chose to participate in voice therapy. The average number of voice therapy sessions for males did not differ, nor did duration of voice therapy. A similar proportion of males and females underwent surgical mass excision. The treatment plan completed differed significantly between males and females with a higher percentage of males choosing to receive no treatment. For 45.54% of males and 59.70% of females the treatment plan consisted of voice therapy only. For 33.33% of males and 37.31% of females, the treatment plan included both voice therapy and surgery. Although gender was the strongest predictor for participation in voice therapy, professional voice uses also predicted participation in voice therapy in both men and women significantly. Professional singing in particular was not a significant predictor for participation in voice therapy. Males were significantly more likely than females to be lost to follow-up before treatment outcome could be assessed CONCLUSION: More females than males were found to have pseudocysts while more males than females had unspecified masses. Females and professional voice users were more willing than males to utilize voice therapy. No difference was found between males and females who decided to have surgery. The best treatment regimen for vocal fold mass is a combination of voice therapy and surgery, when necessary, but gender-specific differences merit further research as well as reconsideration of therapy approaches and strategies to optimize patient compliance.
本研究旨在探讨良性声带肿块治疗中与性别相关的差异。
回顾性分析经频闪喉镜检查诊断为声带肿块的成年患者。收集患者的人口统计学、既往病史、实验室数据以及初诊和随访时的检查结果。分析男性和女性患者的语音治疗持续时间和手术发生率。
共纳入 158 例患者（76 例男性和 82 例女性）。男性和女性患者中专业嗓音使用者的比例存在显著差异。女性声带的反应性肿块比例更高。女性更有可能患有假性囊肿。频闪喉镜检查时，男性声带肿块的未特定类别比例更高。女性异常高的 shimmer 值和异常低的最大发音时间比例显著更高；与男性相比，女性选择接受语音治疗的比例显著更高。男性语音治疗的平均次数和治疗持续时间无差异。男性和女性行肿块切除术的比例相似。男女之间的治疗方案完成情况存在显著差异，男性选择不接受治疗的比例更高。45.54%的男性和 59.70%的女性的治疗方案仅包括语音治疗。33.33%的男性和 37.31%的女性的治疗方案包括语音治疗和手术。尽管性别是决定是否接受语音治疗的最强预测因素，但职业嗓音使用者也是男性和女性接受语音治疗的显著预测因素。特别是职业歌唱者并不是接受语音治疗的显著预测因素。男性在接受治疗结果评估之前失访的比例显著高于女性。
与男性相比，女性更有可能患有假性囊肿，而男性更有可能患有未特定的肿块。女性和职业嗓音使用者比男性更愿意接受语音治疗。决定手术的男性和女性之间没有差异。声带肿块的最佳治疗方案是语音治疗和手术相结合，必要时还需要结合其他治疗方法，但需要进一步研究性别差异，并重新考虑治疗方法和策略，以提高患者的依从性。
