The Sean Parker Institute for the Voice, Department of Otolaryngology - Head & Neck Surgery, Weill Cornell Medical College, New York, New York, USA.
Division of Otolaryngology - Head & Neck Surgery, Stony Brook University, Stony Brook, New York, USA.
Laryngoscope. 2022 Dec;132(12):2434-2441. doi: 10.1002/lary.30072. Epub 2022 Feb 25.
Acute vocal fold edema (VFE) is often a consequence of illness, allergy, or voice overuse, causing dysphonia. Although VFE typically resolves with voice rest and treatment of predisposing causes, oral glucocorticoids are often considered for performers with imminent performance demands. There are limited data about performers' perceptions of vocal change during treatment and how this relates to their ability to perform. This study aims to examine performers' self-perceptions of vocal function with steroid treatment.
Fifty-five performers (34 F; 21 M) diagnosed with VFE who chose treatment with a 6-day methylprednisolone taper were prospectively assessed. They completed the Evaluation of the Ability to Sing Easily (EASE) and reported on their voice use, regimen, performance obligations, and ability to perform. Findings were compared between Day 1 and Day 6 using paired t-tests and nonparametric Wilcoxon signed-rank tests.
Nearly all subjects completed scheduled performances without interruption. Following treatment, all subscales of the EASE were decreased at Day 6 (Vocal Function 29.78-20.59; Pathologic Risk Indicator 26.60-17.33; Vocal Concerns 6.10-4.20). These differences were statistically significant (p < 0.0001) and greater in subjects with performances scheduled and subjects who consistently completed vocal warmups. These findings demonstrate significant improvement in several facets of performers' self-perception of function.
Subjects reported significant improvement in vocal function with oral steroid treatment and were able to meet performance obligations. It remains important that steroids are not prescribed without laryngeal examination. Examination should be repeated when dysphonia persists, recurs swiftly, or when patients seek repeated treatment, as there may be increased risk of adverse outcomes, and continued steroid use may mask underlying chronic pathology that is best treated by other means.
4 Laryngoscope, 132:2434-2441, 2022.
急性声带水肿（VFE）通常是疾病、过敏或过度用声的结果，导致发音困难。尽管 VFE 通常通过声带休息和治疗潜在病因而得到解决，但对于有紧急表演需求的表演者，常考虑口服糖皮质激素治疗。关于表演者在治疗期间对声音变化的感知以及这如何影响他们的表演能力的相关数据有限。本研究旨在检查表演者在接受类固醇治疗时对其发声功能的自我感知。
55 名被诊断为 VFE 的表演者（34 名女性；21 名男性）选择接受为期 6 天的甲泼尼龙递减疗法治疗，他们前瞻性地进行了评估。他们完成了《轻松歌唱能力评估》（EASE），并报告了他们的声音使用、方案、表演义务和表演能力。使用配对 t 检验和非参数 Wilcoxon 符号秩检验比较第 1 天和第 6 天的结果。
几乎所有患者都能按计划完成表演，未出现中断。治疗后，EASE 的所有分量表在第 6 天均下降（发声功能 29.78-20.59；病理性风险指标 26.60-17.33；发声顾虑 6.10-4.20）。这些差异具有统计学意义（p<0.0001），且在有表演计划和一贯完成声乐热身的患者中更为显著。这些发现表明，患者自我感知功能的多个方面均有显著改善。
患者报告称，口服类固醇治疗可显著改善嗓音功能，并且能够满足表演义务。在没有喉镜检查的情况下开具类固醇药物处方仍然是不合适的。当发音困难持续存在、迅速复发或患者寻求重复治疗时，应重复进行检查，因为可能存在不良后果风险增加的情况，并且持续使用类固醇可能会掩盖最佳治疗方法为其他手段的潜在慢性病理。
4 级喉镜，132:2434-2441，2022。
