Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
Department of Otolaryngology-Head & Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, Brussels, Belgium.
J Otolaryngol Head Neck Surg. 2023 Sep 12;52(1):59. doi: 10.1186/s40463-023-00664-3.
To study the post-operative evolution of voice quality of patients treated by transoral CO laser microsurgery (TLM) according to the age.
Patients treated by type I to VI TLM and post-operative speech therapy were prospectively recruited from our hospital. The voice quality was assessed pre-, 1-, 3- 6- and 12-month posttreatment with voice handicap index (VHI), dysphonia, roughness, breathiness, asthenia, strain (GRBAS), maximal phonation time (MPT), F0, F0 standard deviation (STD), percent jitter, percent shimmer, noise-to-harmonic ratio (NHR), vocal fold vibration assessment and speech fluency. Evolution of voice outcomes was analyzed considering age of patients (< 60 vs. ≥ 60 years).
Seventy-five patients completed the evaluations. Thirty-four and forty-one patients were < 60 or ≥ 60 yo, respectively. Subjective and objective voice parameters (VHI, G, R, B), jitter and fluency significantly improved from 1- to 6-month post-TLM in < 60 yo individuals. The voice parameters improved 12-month post-TLM in the ≥ 60 yo group at the exception of VHI that improved 3-month post-TLM. There were positive associations between age and 12-month NHR, G and A parameters.
The post-operative evolution of voice quality parameters may vary between patients according to the age. Preoperative VHI is predictive of 12-month subjective and objective voice outcomes.
根据年龄研究经口 CO2 激光微创手术(TLM)治疗患者的术后嗓音质量变化。
前瞻性招募了我院接受 I 型至 VI 型 TLM 治疗和术后言语治疗的患者。在治疗前、治疗后 1、3、6 和 12 个月,使用嗓音障碍指数(VHI)、声扰度、粗糙声、气息声、无力声、紧张度(GRBAS)、最大发音时间(MPT)、基频(F0)、基频标准差(STD)、微扰率、振幅微扰率、噪声与谐噪比(NHR)、声带振动评估和言语流畅度评估嗓音质量。考虑患者年龄(<60 岁与≥60 岁),分析嗓音结果的变化。
75 例患者完成了评估。34 例和 41 例患者年龄分别<60 岁和≥60 岁。<60 岁的患者,主观和客观嗓音参数(VHI、G、R、B)、微扰率和流畅度从 TLM 后 1 个月到 6 个月显著改善。≥60 岁的患者,除了 VHI 从 TLM 后 3 个月开始改善外,12 个月时嗓音参数也得到了改善。年龄与 12 个月时的 NHR、G 和 A 参数之间存在正相关。
根据年龄,患者术后嗓音质量参数的变化可能不同。术前 VHI 可预测 12 个月时的主观和客观嗓音结果。