Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
Unità Operativa Complessa di Otorinolaringoiatria, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.
J Voice. 2024 Nov;38(6):1525.e15-1525.e22. doi: 10.1016/j.jvoice.2022.04.005. Epub 2022 May 28.
To evaluate results of telerehabilitation (TR) during the coronavirus disease 2019 pandemic for the treatment of dysphonia caused by permanent post-thyroidectomy unilateral vocal fold paralysis (UVFP).
Forty subjects with post-thyroidectomy UVFP (onset <1 month) underwent TR. Videostrobolaryngoscopy, acoustic and perceptual voice analysis and patient self-assessment were carried out in person before, at the end of TR and 6 months later.
Twenty-five subjects spontaneously recovered full vocal fold motility at some time during follow-up, whereas 15 had a permanent UVFP at the end of the follow-up period. These subjects constituted our study group. At the early posttherapy control 10/15 subjects (66.6%) showed a complete glottal closure, while in 5/15 (33.3%) a glottal gap remained (P = 0.03). These results did not change 6 months after TR. At the late posttherapy control the maximum phonation time improved significantly (P = 0.02). Both post-therapy Voice Handicap Index scores were significantly lower than the pre-therapy ones (P = 0.04). Grade, Breathiness, and Asthenia parameters of the Grade-Roughness-Breathiness-Asthenia-Strain scale improved 6 months after TR (P < 0.05). The number of voice signals suitable for acoustic analysis increased significantly after therapy. Finally, 87% of patients were satisfied with TR.
With careful patient selection, TR may be considered as a promising method for voice therapy in postthyroidectomy UVFP.
评估 2019 年冠状病毒病大流行期间远程康复（TR）治疗永久性甲状腺切除术后单侧声带麻痹（UVFP）所致发声障碍的效果。
40 例甲状腺切除术后 UVFP（发病<1 个月）患者接受 TR。在 TR 前后及 6 个月后，分别进行视频频闪喉镜、声学和感知语音分析及患者自我评估。
25 例患者在随访过程中声带运动功能在某一时间自发恢复，15 例患者在随访结束时仍存在永久性 UVFP。这些患者构成了我们的研究组。在早期治疗后控制时，15 例患者中有 10 例（66.6%）出现完全声门闭合，而在 5 例（33.3%）中仍存在声门间隙（P=0.03）。这些结果在 TR 后 6 个月没有改变。在晚期治疗后控制时，最大发音时间显著改善（P=0.02）。治疗后的嗓音障碍指数评分均显著低于治疗前（P=0.04）。嗓音障碍指数 6 个月后，声级、粗糙声、气息声和无力声参数均有改善（P<0.05）。治疗后适合声学分析的嗓音信号数量显著增加。最后，87%的患者对 TR 满意。
通过仔细选择患者，TR 可被视为甲状腺切除术后 UVFP 嗓音治疗的一种有前途的方法。
