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富血小板血浆注射对嗓音手术后短期嗓音效果的影响:一项初步研究。

The Effect of Platelet-Rich Plasma Injection on Short Term Vocal Outcomes Following Phonosurgery-A Pilot Study.

机构信息

Department of Otolaryngology, "Iuliu Hatieganu" University of medicine and Pharmacy, Cluj, 400349 Cluj-Napoca, Romania.

Cluj County Emergency Hospital, Cluj, 400006 Cluj-Napoca, Romania.

出版信息

Medicina (Kaunas). 2022 Jul 25;58(8):988. doi: 10.3390/medicina58080988.

Abstract

The efficiency and optimal voice rest period following phonosurgery remains debatable. Platelet-rich plasma (PRP) is a safe and cheap alternative to many bioactive agents being studied on animal models, and is already in use in many medical areas. We investigate the short-term effects of PRP and voice rest on voice outcomes following phonosurgery as an alternative to voice rest alone. A prospective single-blinded pilot study was conducted. Sixteen patients with a diagnosis of vocal fold cyst and polyps were included, forming equal groups (PRP and voice rest vs. voice rest alone). Voice analysis was carried out on the preoperative day, day three, and week three following surgery. The measured parameters were fundamental frequency (F0), noise-signal ratio (NSR), harmonic poverty (HP), attack alteration (AL), pitch instability (PI), and amplitude instability (AI).VHI(Voice Handicap Index)-30 questionnaires were carried out before surgery and three weeks following surgery to assess the impact of subjective voice change on quality of life. PRP was obtained using commercial kits with separator gel. An average 3.68-fold increase in platelets was obtained with PRP. No side effects were noted after injection. All voice parameters improved on day three and week three following surgery. Statistical significance was noted only in the fundamental frequency of male patients ( = 0.048) in favor of the PRP-voice rest group. In addition, the VHI- 30 questionnaire results between preoperative and postoperative assessments showed statistically significant differences in total VHI score ( = 0.02) as well as the physical ( = 0.05) and emotional ( = 0.02) scale in favor of the PRP-voice rest group. PRP presents short term safety in patients who undergo phonosurgery, although long-term outcomes are unknown. PRP and voice rest are superior to voice rest alone when considering subjective assessment of the voice. When analyzing acoustic parameters, PRP and voice rest are not superior to voice rest alone.

摘要

声带息肉切除术和声带休息后声音恢复的效率和最佳恢复期仍存在争议。富含血小板的血浆(PRP)是许多正在动物模型中研究的生物活性药物的安全且廉价的替代品,并且已经在许多医学领域中使用。我们研究了 PRP 和声带休息对声带息肉切除术患者短期嗓音效果的影响,作为单独声带休息的替代方法。

进行了一项前瞻性单盲试点研究。共纳入 16 例声带囊肿和息肉患者,分为两组(PRP 和声带休息组与单独声带休息组)。在术前、术后第 3 天和第 3 周进行嗓音分析。测量的参数包括基频(F0)、噪声信号比(NSR)、谐波减少(HP)、起音变化(AL)、音高不稳定性(PI)和幅度不稳定性(AI)。在手术前和手术后 3 周进行 VHI(嗓音障碍指数)-30 问卷调查,以评估主观嗓音变化对生活质量的影响。使用商用试剂盒和分离凝胶获得 PRP。PRP 血小板平均增加 3.68 倍。注射后无不良反应。术后第 3 天和第 3 周所有嗓音参数均改善。仅在男性患者的基频上具有统计学意义(=0.048),有利于 PRP-声带休息组。此外,术前和术后评估的 VHI-30 问卷结果在总 VHI 评分(=0.02)以及身体(=0.05)和情感(=0.02)方面均具有统计学差异,有利于 PRP-声带休息组。

PRP 为接受声带息肉切除术的患者提供了短期安全性,但长期效果尚不清楚。在考虑嗓音的主观评估时,PRP 和声带休息比单独声带休息更有效。在分析声学参数时,PRP 和声带休息并不优于单独声带休息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe24/9331366/cc5b2a7d4b3e/medicina-58-00988-g001.jpg

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