喉环状软骨上部分切除环舌骨会厌固定术后患者发声功能评估及其影响因素分析

The Objective Voice Assessment and Analysis of Impact Factors after Supracricoid Partial Laryngectory with Cricohyoidoepiglottopexy

赵峰;黄小英;赵冲;苏纪平;

1:广西医科大学第一附属医院耳鼻咽喉头颈外科

2:西南医科大学附属医院耳鼻咽喉头颈外科

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摘要

目的客观评价喉环状软骨上部分切除环舌骨会厌固定术(supracricoid partial laryngectomy with cricohyoidoepiglottopexy,SCPL-CHEP)后患者的发声功能,探讨影响其嗓音质量的相关因素。方法选取2009年6月至2014年12月行SCPL-CHEP手术1.5～68个月后(中位时间为11.5个月)的46例喉癌患者为研究组,另选取20例正常成年男性为对照组,分别采集并比较两组对象发声的基频(F0)、基频微扰(jitter)、振幅微扰(shimmer)、最长发声时间(maximum phonation time,MPT),结合患者年龄、T分期、肿瘤分型、术中重建披裂、保留的环杓单位完整性个数、术后放疗及术后时间等临床资料,分析可能影响新喉发音的相关因素。结果 SCPL-CHEP术后患者的嗓音F0、MPT低于正常同龄男性(P<0.05),jitter、shimmer值则高于正常同龄男性(P<0.05);Spearman’s相关性分析表明,F0与T分期、术中重建披裂、肿瘤分型呈负相关(r=-0.307,P=0.038;r=-0.390,P=0.007;r=-0.291,P=0.050);jitter与术后放疗呈负相关(r=-0.329,P=0.026);shimmer与术后时间呈正相关(r=0.332,P=0.024),与肿瘤分型呈负相关(r=-0.332,P=0.024);MPT与术后时间呈正相关(r=0.296,P=0.046)。结论 SCPL-CHEP术后患者嗓音质量差,术前病变范围越广,患者术后发音时F0下降、shimmer升高越明显;术后放疗可降低jitter;随着术后时间的延长,患者MTP延长。

关键词

喉癌;环舌骨会厌固定术;嗓音质量

基金项目(Foundation):

作者

赵峰;黄小英;赵冲;苏纪平;

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喉癌环舌骨会厌固定术嗓音质量

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赵峰黄小英赵冲苏纪平