Free Nicole, Stemple Joseph C, Smith Julian A, Phyland Debra J
Department of Surgery, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
Department of Communication Sciences and Disorders, and Rehabilitation and Health Sciences PhD Program, University of Kentucky, Lexington, Kentucky.
J Voice. 2025 Jul;39(4):1118-1129. doi: 10.1016/j.jvoice.2023.01.019. Epub 2023 Feb 20.
To examine the variability of lesion characteristics and vocal function in female speakers with phonotraumatic vocal fold lesions (PVFLs).
Prospective Cohort Study METHODS: Thirty adult female speakers with PVFL who were participating in voice therapy were recruited to complete a multidimensional voice analysis at four time points across 1 month. Analysis comprised self-ratings of effort and vocal function, expert ratings of videostroboscopy and audio recordings, and instrumental evaluation by selected aerodynamic and acoustic parameters. The degree of variability across time for each individual was assessed against a minimal clinically important difference threshold.
A high degree of variability across time was observed for participant self-ratings of perceived effort and vocal function, and for instrumental parameters. The greatest degree of variability was observed in aerodynamic measures of airflow and pressure, and the acoustic parameter semitone range. Comparatively less variability was observed in perceptual evaluation of speech, and lesion characteristics via stroboscopy still images. Findings suggest that individuals with all PVFL types and sizes present with variability in function across time, with the greatest degree of variability in function observed in participants with large lesions and vocal fold polyps.
Variability is observed in voice characteristics of female speakers with PVFLs across 1 month despite general stability in lesion presentation, suggesting vocal function can change despite the presence of laryngeal pathology. This study highlights the need to explore individual functional and lesion responses across time to determine potential for change and improvement in both aspects when selecting treatment options.
研究患有发声创伤性声带病变（PVFL）的女性说话者的病变特征和发声功能的变异性。
前瞻性队列研究
招募30名参与嗓音治疗的患有PVFL的成年女性说话者，在1个月内的四个时间点完成多维嗓音分析。分析包括对用力程度和发声功能的自我评估、频闪喉镜检查和录音的专家评估，以及通过选定的空气动力学和声学参数进行仪器评估。根据最小临床重要差异阈值评估每个个体随时间的变异程度。
观察到参与者对感知用力程度和发声功能的自我评估以及仪器参数随时间有高度变异性。在气流和压力的空气动力学测量以及声学参数半音范围中观察到最大程度的变异性。在言语的感知评估以及通过频闪喉镜静态图像观察到的病变特征方面，变异性相对较小。研究结果表明，所有类型和大小的PVFL个体的功能随时间存在变异性，在患有大病变和声带息肉的参与者中观察到的功能变异性最大。
尽管病变表现总体稳定，但患有PVFL的女性说话者在1个月内的嗓音特征存在变异性，这表明尽管存在喉部病变，发声功能仍可能发生变化。本研究强调需要探索个体随时间的功能和病变反应，以确定在选择治疗方案时这两个方面变化和改善的潜力。
