Kasemsiri Pornthep, Duangthongphon Pichayen, Prathanee Benjamas, Thongrong Cattleya
Department of Otorhinolaryngology, Srinagarind Hospital, Faculty of Medicine Khon Kaen University Khon Kaen Thailand.
Srinagarind Minimally Invasive Surgery Center of Excellence, Faculty of Medicine Khon Kaen University Khon Kaen Thailand.
Laryngoscope Investig Otolaryngol. 2021 Nov 19;6(6):1275-1282. doi: 10.1002/lio2.701. eCollection 2021 Dec.
To study the effect of endoscopic endonasal transsphenoidal surgery on voice quality in patients with pituitary lesions.
An observational study comparing voice quality before and after surgery was conducted between September 2015 and September 2017 at Srinagarind Hospital, Khon Kaen University, Thailand. Pituitary tumor patients who underwent endoscopic endonasal transsphenoidal surgery were recruited. The nasal corridors were created with a type I (preserving both middle turbinates with a rescue flap) or type II (cutting one middle turbinate with a raised nasoseptal flap) for the binostril with four-hand technique. All patients were evaluated for nasal resonance, acoustic parameters, acoustic perception, and self-assessment of their satisfaction with postoperative voice changes with a visual analog scale (VAS). The patients were evaluated 1 day before surgery and at 1 and 3 months after surgery.
Forty-four patients, including 19 males and 25 females with a mean age of 50.0 ± 15.6 years, were enrolled. Mean scores for nasal resonance and all acoustic parameters were not significantly changed after surgery for either nasal corridor type ( > .05). Regarding acoustic perception, word and sentence and GIRBAS scores showed no significant difference before and after surgery ( > .09) in either type of nasal corridor. There was no incidence of hypernasality voice after surgery. Patients' self-satisfaction ratings (i.e., VAS) with voice quality were high and showed no significant change 1 and 3 months postsurgery ( > .05).
These endoscopic endonasal transsphenoidal approaches are minimally invasive skull base surgery techniques that have minimal effects on postsurgery voice quality.
This trial was registered at ClinicalTrial.gov (NCT02828514).
研究鼻内镜下经鼻蝶窦手术对垂体病变患者嗓音质量的影响。
2015年9月至2017年9月在泰国孔敬大学诗里拉吉医院开展了一项观察性研究，比较手术前后的嗓音质量。招募接受鼻内镜下经鼻蝶窦手术的垂体瘤患者。采用四手操作技术，为双侧鼻腔制作Ⅰ型（保留双侧中鼻甲并带有备用瓣）或Ⅱ型（切除一侧中鼻甲并带有掀起的鼻中隔瓣）鼻腔通道。采用视觉模拟量表（VAS）对所有患者的鼻腔共鸣、声学参数、声学感知以及对术后嗓音变化的自我满意度进行评估。在手术前1天以及术后1个月和3个月对患者进行评估。
共纳入44例患者，其中男性19例，女性25例，平均年龄50.0±15.6岁。两种鼻腔通道类型术后鼻腔共鸣及所有声学参数的平均得分均无显著变化（P＞0.05）。在声学感知方面，两种鼻腔通道类型的单词、句子及GIRBAS评分在手术前后均无显著差异（P＞0.09）。术后未发生鼻音过重的情况。患者对嗓音质量的自我满意度评分较高，术后1个月和3个月无显著变化（P＞0.05）。
这些鼻内镜下经鼻蝶窦入路是微创颅底手术技术，对术后嗓音质量影响极小。
本试验在ClinicalTrial.gov（NCT02828514）注册。
4级。
