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[声带纤维囊性变的治疗效果分析]

[Analysis of therapeutic effect of fibrocystic degeneration of vocal folds].

作者信息

Jin Jianbo, Zeng Shuyi, Zhuang Peiyun

机构信息

The Graduate School of Fujian Medical University,Fuzhou,350122,China.

Department of Voice Medicine,Xiamen University Zhongshan Hospital,Xiamen Key Laboratory of Voice Medicine Xiamen.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Oct;38(10):935-939;946. doi: 10.13201/j.issn.2096-7993.2024.10.010.

Abstract

To explore the differences in clinical presentation and therapeutic outcomes between vocal fold fibrocystic degeneration and other common benign lesions, such as vocal fold polyp and cyst. Vocal function was assessed before and after surgery in 10 cases of vocal fold fibrocystoids, 30 cases of vocal fold polyps and 10 cases of vocal fold cysts at Department of Voice Medicine, Xiamen University Zhongshan Hospital. The voice Assessments included GRBAS(G-scale), VHI-10 scale, Reflux Symptom Index(RSI) scale, stroboscope, acoustic objective analysis, and aerodynamics measurements. The acoustice analysis parameters included fundamental frequency(F0), fundamental frequency perturbation(Jitter), amplitude perturbation(Shimmer) and voice disturbance severity index(DSI), while the maximum phonation time(MPT) was assessed for aerodynamics. Stroboscopic parameters included vocal fold straightness, vocal fold color, glottic closure and mucosal wave. All three groups underwent phonomicrosurgery and a follow-up review was conducted one month later. Pre-and post-operative function assessment parameters were compared across the three groups. Significant differences were founded in the G grade, Jitter, Shimmer, DSI, glottic closure and mucosal wave between the vocal fold fibrocystic degeneration group and the vocal fold polyp and vocal fold cyst group(<0.05). Most voice function parameters in all three groups showed significant improvement after surgery(<0.05). The improvement of VHI(10), RSI and mucosal wave scores in the vocal fold fibrocystic lesion group was significantly different from that of the vocal fold polyp group(<0.05). Vocal fold fibrocystic degeneration is a more severe than that of vocal fold polyps and cysts, which are two common benign vocal fold lesions. Phonomicrosurgery is an effective treatment for vocal fold fibrocystic degeneration, but its curative effect are less favorable compared to those for vocal fold polyps and vocal fold cysts. Therefore, a detailed preoperative evaluation is essential for predicting surgical outcomes.

摘要

探讨声带纤维囊性变与其他常见良性病变(如声带息肉和囊肿)在临床表现和治疗效果上的差异。厦门大学附属中山医院嗓音医学科对10例声带纤维囊样变、30例声带息肉和10例声带囊肿患者在手术前后进行了嗓音功能评估。嗓音评估包括GRBAS(G级)、VHI - 10量表、反流症状指数(RSI)量表、频闪喉镜、声学客观分析及空气动力学测量。声学分析参数包括基频(F0)、基频微扰(抖动)、幅度微扰(闪烁)及嗓音障碍严重程度指数(DSI),空气动力学方面评估了最长发声时间(MPT)。频闪喉镜参数包括声带平直度、声带颜色、声门闭合及黏膜波。三组均接受了显微喉镜手术,并在1个月后进行了随访复查。对三组手术前后的功能评估参数进行了比较。声带纤维囊性变组与声带息肉组及声带囊肿组在G级、抖动、闪烁、DSI、声门闭合及黏膜波方面存在显著差异(<0.05)。三组术后多数嗓音功能参数均有显著改善(<0.05)。声带纤维囊性病变组VHI(10)、RSI及黏膜波评分的改善与声带息肉组有显著差异(<0.05)。声带纤维囊性变比声带息肉和囊肿这两种常见的声带良性病变更为严重。显微喉镜手术是治疗声带纤维囊性变的有效方法,但其疗效与声带息肉和声带囊肿相比欠佳。因此,详细的术前评估对于预测手术效果至关重要。

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