声带类固醇注射治疗良性声带病变的年龄依赖性治疗效果。
Age-dependent treatment effect of vocal fold steroid injection for benign vocal fold lesions.
作者信息
Nozawa Miki, Kanazawa Takeharu, Kurakami Kazuya, Kashima Kazutaka, Okui Ayako, Hasegawa Tomohiro, Hirosaki Mayu, Kamitomai Manami, Igarashi Takeshi, Ito Makoto, Watanabe Yusuke
机构信息
Division of Laryngeal Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine Jichi Medical University Shimotsuke Japan.
Department of Otolaryngology-Head and Neck Surgery, School of Medicine Jichi Medical University Shimotsuke Japan.
出版信息
Laryngoscope Investig Otolaryngol. 2023 Jan 2;8(1):177-184. doi: 10.1002/lio2.997. eCollection 2023 Feb.
OBJECTIVE
Benign vocal fold lesions (BVFLs) cause voice disorders and impair social life. Recently, office-based vocal fold steroid injection (VFSI) has gained attention as a minimally invasive treatment for BVFLs. This study aimed to analyze the age-dependent treatment effect of VFSI and to clarify the indications for treatment.
METHODS
In this retrospective cohort study, a total of 83 patients with BVFLs were treated with a similar regimen of VFSI. Three or four months after the injection, age-dependent phonological functions were evaluated. The differences between pre- and post-treatment findings were analyzed using the Wilcoxon matched-pair signed-rank test, and the correlation between patient age and improvement rates were determined by Pearson's correlation coefficient.
RESULTS
Improvement in voice handicap index (VHI), which was the primary endpoint, was observed. Subjective and objective voice quality measurements also showed significant improvements. Subgroup analyses revealed that there was no age-related difference in the improvement of voice quality and that there was no improvement in aerodynamic effect in patients over 45 years of age.
CONCLUSION
This study clarified the age-dependent treatment effect of VFSI and provided the important suggestion of establishing indication criteria for BVFLs. The study results provided clarity on the indication criteria of VFSI and served as an important indicator for tailoring treatment to patients' needs.
LEVEL OF EVIDENCE
目的
良性声带病变（BVFLs）会导致嗓音障碍并损害社交生活。近来，门诊声带类固醇注射（VFSI）作为一种治疗BVFLs的微创疗法受到关注。本研究旨在分析VFSI的年龄依赖性治疗效果并明确治疗指征。
方法
在这项回顾性队列研究中，共有83例BVFLs患者接受了类似方案的VFSI治疗。注射后三或四个月，评估年龄依赖性语音功能。使用Wilcoxon配对符号秩检验分析治疗前后结果的差异，并通过Pearson相关系数确定患者年龄与改善率之间的相关性。
结果
观察到作为主要终点的嗓音障碍指数（VHI）有所改善。主观和客观嗓音质量测量也显示出显著改善。亚组分析显示，嗓音质量改善方面不存在年龄相关差异，且45岁以上患者的空气动力学效应未得到改善。
结论
本研究明确了VFSI的年龄依赖性治疗效果，并为建立BVFLs的指征标准提供了重要建议。研究结果明确了VFSI的指征标准，并为根据患者需求定制治疗提供了重要指标。
证据水平
4级。
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