声带息肉患者术后声休方案探讨

The Study of the Postoperative Voice Rest Treatment for Patients with Vocal Fold Polyps

李翠娥;周涛;屈季宁;陶泽璋;

1:武汉大学人民医院耳鼻咽喉头颈外科

摘要

目的探讨声带息肉患者喉显微手术后声休方案。方法 85例声带息肉患者随机分为两组,A组48例,B组37例,均在显微支撑喉镜下行声带息肉切除术,A组术后严格声休1周,B组术后严格声休2周,其余治疗相同。两组均于手术前和手术后1、2、3、4周行嗓音基频微扰(jitter)、振幅微扰(shimmer)、噪谐比(NHR)检测和纤维喉镜检查,比较两组术后发声功能及声带手术创面恢复情况。结果术后1周时A、B两组jitter、shimmer、NHR值均与术前比较差异无统计学意义(P>0.05);术后2周时,A组仅jitter较术前降低(P<0.05),shimmer、NHR值仍与术前无差异,而B组jitter、shimmer、NHR值均较术前降低(P<0.05),且B组shimmer值较A组低(P<0.05);术后3周时B组jitter、shimmer、NHR值均低于A组;术后4周时两组jitter、shimmer、NHR值均恢复至正常水平。纤维喉镜检查显示术后1周时两组患者术侧声带均有不同程度充血水肿,部分患者创面可见少许伪膜;术后2周时声带充血水肿逐渐消退,伪膜脱落;至术后4周时,两组患者术侧声带外观完全恢复正常。结论声带息肉患者术后2周应严格声休,术后3-4周应相对声休,以利于声带创面的愈合及发声功能的恢复。

关键词

声带息肉;声休;嗓音声学分析

基金项目(Foundation):

作者

李翠娥;周涛;屈季宁;陶泽璋;

参考文献

1 Behrman A,Sulica L.Voice rest after microlaryngoscopy:currentopinion and practice[J].Laryngoscope,2003,113:2182.

2 Sataloff RT.Voice rest[M].In:Sataloff RT,ed.Profession-al Voice:The science and art of clinical care.San Diego,CA:Singular Publishing Group,1997.453-456.

3 Werkhaven J,Ossoff RH.Surgery for benign lesions of theglottis[J].Otolaryngol Clin North Am,1991,24:1 179.

4 Koufman JA,Blalock PD.Is voice rest never indicated[J]?JVoice,1989,3:87.

5 Ishikawa K,Thibeault S.Voice rest verse exercise:a review ofthe literature[J].Journal of Voice,2010,24:379.

6 Haben CM.Voice rest and phonotrauma in singers[J].MedProbl Perform Art,2012,27:165.

7 Fletcher HM,Drinnan MJ,Carding PN.Voice care knowl-edge among clinicians and people with healthy voice or dyspho-nia[J].Journal of Voice,2007,21:80.

8 Rousseau B,Cohen SM,Zeller AS,et al.Compliance andquality of life in patients on prescribed voice rest[J].Otolaryn-gol Head Neck Surg,2011,144:104.

9 毛华东,屈季宁,周涛.单侧声带息肉患者喉显微手术后嗓音特征的动态观察[J].听力学及言语疾病杂志,2009,17:157.

10 Thibeault SL,Gray SD.Vocal fold injury and repair[M].In:Sataloff RT,ed.Voice Science.San Diego,CA:Plural Pub-lishing,2005.105-113.

11 Tateya I,Tateya T,Lim X,et al.Cell production in injuredvocal folds:a rat study[J].Ann Otol Rhinol Laryngol,2006,115:135.

12 Tateya T,Tateya I,Sohn JH,et al.Histological study of a-cute vocal fold injury in a rat model[J].Ann Otol Rhinol La-ryngol,2006,115:285.

13 Liu M,Post M.Invited review:mechanochemical signal trans-duction in the fetal lung[J].J Appl Physiol,2000,89:2 078.

14 Altman GH,Horan RL,Martin I,et al.Cell differentiationby mechanical stress[J].Faseb J,2002,16:270.

15 Titze IR.Principles of voice production[M].EnglewoodCliffs,NJ:Prentice Hall,1994.31-40.

16 Verdolini Abbott K,Li NY,Branski RC,et al.Vocal exer-cise may attenuate acute vocal fold inflammation[J].J Voice,2012,26:814.e1.

17 Gray SD,Hammond E,Hanson DF.Benign pathologic re-sponses of the larynx[J].Ann Otol Rhinol Laryngol,1995,104 :13.

18 Gray S,Titze I.Histologic investigation of hyperphonatedcanine vocal cords[J].Ann Otol Rhinol Laryngol,1988,97(4Pt 1):381.

19 Cho SH,Kim HT,Lee IJ,et al.Influence of phonation onbasement membrane zone recovery after phonomicrosurgery:a canine model[J].Ann Otol Rhinol Laryngol,2000,109:658 .

20 Thibeault SL,Gray SD,Bless DM,et al.Histologic andrheologic characterization of vocal fold scarring[J].J Voice,2002,16:96.

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声带息肉声休嗓音声学分析

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李翠娥周涛屈季宁陶泽璋