手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效分析

The Effects of Phonosurgery Combined with Voice Therapy for Vocal Polyps Accompanied with Muscle Tension Dysphonia

高晓葳;黄永望;刘丽燕;李超;牛俊涛;傅德慧;欧阳杰;

1:天津医科大学第二医院耳鼻咽喉科

摘要

目的探讨手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效。方法 117例伴肌紧张性发声障碍的声带息肉患者分为单纯手术组(手术组,57例)和手术联合嗓音训练组(联合组,60例),另随机选取50例无嗓音疾患的正常人作为正常对照组。采用Xion声学分析软件对正常对照组及手术组、联合组患者治疗前后的嗓音基频微扰(jitter)、振幅微扰(shimmer)、嗓音障碍指数(DSI)进行测试并比较。结果手术组、联合组治疗后jitter和shimmer值均较治疗前明显降低,DSI明显升高(P<0.05),而联合组的jitter和shimmer值更低,DSI值更高(P<0.05);手术组治疗后的jitter和shimmer值高于正常组,DSI值低于正常组(P<0.05);联合组治疗后jitter和shimmer与正常组比较差异无统计学意义(P>0.05)。结论喉显微外科手术联合嗓音训练有助于提高伴肌紧张性发声障碍声带息肉患者手术后的嗓音质量。

关键词

肌紧张性发声障碍;声带息肉;嗓音训练;嗓音外科

基金项目(Foundation):

天津市卫计委科技基金(2014KZ101)资助

作者

高晓葳;黄永望;刘丽燕;李超;牛俊涛;傅德慧;欧阳杰;

参考文献

1 Altam KW,Atkinson C,Lazarus C.Current and emerging concepts in muscle tension dysphonia:a 30-month review[J].J Voice,2005,19:261.

2 Koufman JA,Blalock PD.Functional voice disorders[J].Otolaryngol Clin North Am,1991,24:1059.

3 Mathieson L,Hirani SP,Epstein R,et a1.Laryngeal manual therapy:apreliminary study to examine its treatment effects in the management of muscle tension dysphonia[J].J Voice,2009,23:353.

4 Roy N,Leeper HA.Effects of the manual laryngeal musculoskeletal tension reduction technique as a treatment for functional voice disorders:perceptual and acoustic measures[J].J Voice,1993,7:242.

5 Van Lierde KM,Bodt MD,Dhaeseleer E,et al.The treatment of muscle tension dysphonia:a comparison of two treatment techniques by means of an objective multiparameter approach[J].J Voice,2010,24:294.

6 Morrison MD,Rammage LA.Muscle misuse voice disorders:description and classification[J].Acta Otolaryngol,1993,113:428.

7 Franco RA,Andrus JG.Common diagnoses and treatments in professional voice users[J].Otolaryngol Clin North Am,2007,40:1025.

8 Belafsky PC,Postma GN,Reulbach TR,et al.Muscle tension dysphonia as a sign of underlying glottal insufficiency[J].Otolaryngol Head Neck Surg,2002,127:448.

9 Morrison MD,Rammage LA,Belisle GM,et al.Muscular tension dysphonia[J].J Otolaryngol,1983,12:302.

10 Hsiung MW,Hsiao YC.The characteristic features of muscle tension dysphonia before and after surgery in benign lesions of the vocal fold[J].ORL J Otorhinolaryngol Relat Spec,2004,66:246.

11 Sama A,Carding PN,Price S,et al.The clinical features of functional dysphonia[J].Laryngoscope,2001,111:458.

12 Petrovi'c-Lazi'c M,Babac S,Vukovi'c M,et al.Acoustic voice analysis of patients with vocal fold polyp[J].J Voice,2011,25:94.

13 Schindler A,Mozzanica F,Ginocchio D,et al.Vocal improvement after voice therapy in the treatment of benign vocal fold lesions[J].Acta Otorhinolaryngol Ital,2012,32:304.

本文信息

PDF(106K)

本文关键词相关文章

肌紧张性发声障碍声带息肉嗓音训练嗓音外科

本文作者相关文章

高晓葳黄永望刘丽燕李超牛俊涛傅德慧欧阳杰