Dubey Priya, Fernandes Jacqueline B, Bhat Mahesh
Department of ENT, Father Muller Medical College, Mangalore, India.
Bhopal, India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1973-1978. doi: 10.1007/s12070-020-01934-6. Epub 2020 Jul 6.
Laryngopharyngeal cancers are one of the most commonly diagnosed head and neck malignancies frequently presenting primarily with change in voice. Radiotherapy being the main modality of treatment for early cancers continues to affect voice. Hence, acoustic analysis of the voice offers quantifiable values of several parameters delineating the obvious effect of the therapy. A total number of 60 patients, diagnosed with laryngopharyngeal cancers undergoing radiotherapy underwent acoustic voice assessment using Dr. speech software pre-treatment and at 1 and 3 months post radiotherapy. Data analysis was done using Mann-Whitney test and Wilcoxon signed rank test and a significant p value was obtained. The results of the study showed fundamental frequency (F0) and noise to harmonic ratio (NHR) to be the most affected in comparison to Jitter and Shimmer. The F0 and NHR values across baseline evaluation, first month and third month follow up showed a steady deterioration which was significant. The deterioration noted from the first to third month was not statistically significant. Across genders both F0 and NHR deterioration is more in males than in females. Radiotherapy causes definitive alterations in some acoustic measures of voice, which make the voice disharmonic and hoarse with contribution of harshness and breathiness. The effect is more pronounced on vocal parameters that are structure and projection based as evidenced by deterioration in values noted in F0 and NHR. Persistent deteriorated acoustic parameters for a longer duration of time are more likely which emphasizes the need for early voice rehabilitation.
喉咽癌是最常被诊断出的头颈部恶性肿瘤之一,主要症状常为声音改变。放疗是早期癌症的主要治疗方式,但仍会影响嗓音。因此,嗓音声学分析能提供多个参数的可量化值,从而描绘出治疗的明显效果。共有60例被诊断为喉咽癌且正在接受放疗的患者,在放疗前以及放疗后1个月和3个月使用Dr. speech软件进行了嗓音声学评估。采用曼-惠特尼检验和威尔科克森符号秩检验进行数据分析,并获得了显著的p值。研究结果表明,与基频微扰和振幅微扰相比,基频(F0)和噪声谐波比(NHR)受影响最大。在基线评估、第一个月和第三个月随访期间的F0和NHR值显示出持续恶化,且具有显著性。从第一个月到第三个月观察到的恶化在统计学上不显著。在不同性别中,男性的F0和NHR恶化程度均高于女性。放疗会导致嗓音的一些声学指标发生明确改变,使嗓音失调且嘶哑,并伴有粗糙感和呼吸音。正如F0和NHR值的恶化所证明的,这种影响在基于结构和发声的嗓音参数上更为明显。更长时间内持续恶化的声学参数更为常见,这强调了早期嗓音康复的必要性。