甲状腺腺瘤患者单侧甲状腺腺叶切除术后嗓音声学分析

The Voice Acoustic Analysis of Unilateral Thyroid Adenoma Patient Underwent Thyroid Gland Lobectomy

夏菲;屈季宁;李翠娥;周涛;

1:武汉大学人民医院耳鼻咽喉-头颈外科

摘要

目的探讨因甲状腺腺瘤行单侧甲状腺腺叶切除术而喉神经未损伤患者的嗓音变化特点。方法对32例(男8例,女24例)术前无自觉声嘶的单侧甲状腺腺瘤成年患者于单侧甲状腺腺叶切除手术前后行纤维喉镜检查和多维嗓音声学分析,并与40例(男女各20例)嗓音正常成年人比较。结果手术前后纤维喉镜检查全部患者声带形态、色泽及运动正常。甲状腺组术前各声学指标与对照组比较,男性差异无统计学意义(P>0.05),而女性的平均基频(F0)和最高基频(Fhi)明显低于对照组(P<0.05);术后1周与术前比较,男性和女性患者F0、Fhi都明显下降(P<0.05),术后1月F0恢复正常,而Fhi在术后3月仍低于术前水平和对照组(P<0.05);女性患者术后1月F0标准差(STD)、基频微扰(Jitt)、振幅微扰(Shim)、噪/谐比(NHR)、嗓音扰动指数(voice turbulence in-dex,VTI)以及次谐波度(degree of subharmonics,DSH)较术前显著降低(P<0.05),但仍高于对照组(P<0.05),术后3月均恢复到正常。结论对于无自觉发声异常的甲状腺腺瘤患者,术前女性嗓音声学分析结果可轻度异常而男性正常;单侧甲状腺腺叶切除术后,男性嗓音声学分析可轻度异常,但一月内恢复正常,而女性嗓音质量虽较术前有所改善,但最高基频在术后3月仍低于正常。

关键词

甲状腺腺叶切除;嗓音

基金项目(Foundation):

作者

夏菲;屈季宁;李翠娥;周涛;

参考文献

1 Mc Lvor NP,Flint DJ,Gillibrand J,et al.Thyroid surgeryand voice-related outcomes[J].Aust N Z J Surg,2000,70:179.

2 Lennquist S,Cahlin C,Smeds S.The superior laryngeal nervein thyroid surgery[J].Surgery,1987,102:999.

3 Stojadinovic A,Shaha AR,Orlikoff RF,et al.Prospectivefunctional voice assessment in patients undergoing thyroid sur-gery[J].Ann Surg,2002,236:823.

4 Hong KH,Ki m YK.Phonatory characteristics of patients un-dergoing thyroidectomy without laryngeal nerve injury[J].O-tolaryngology-Head Neck Surgery,1997,117:399.

5 Sinagra DL,Montesinos MR,Tacchi VA,et al.Voice chan-ges after thyroidectomy without recurrent laryngeal nerveinju-ry[J].J Am Coll Surg,2004,199:556.

6 Soylu L,Ozbas S,Uslu HY,et al.The evaluation of thecause of subjictive voice disturbances after thyriod surgery[J].The American Journal of Surgery,2007,194:317.

7 Dursun G,Sataloff RT,Spiegel JR,et al.Superior laryngealnerve paresis and paralysis.[J]Voice,1996,10:206.

8 de Pedro NettoI,Fae A,Vartanian JG,et al.Voice and vocalself-assessment after thyroidectomy[J].Otolaryngology-Head Neck Surgery,2006,28:1 106.

9 Pereira JA,Girvent M,Sancho JJ,et al.Prevalence of long-termupper aerodigestive symptoms after uncomplicated bilat-eral thyroidectomy[J].Surgery,2003,133:318.

10 Aluffi P,Policarpo M,Cherovac C,et al.Post-thyroidecto-my superior laryngeal nerveinjury[J].Eur Arch Otorhinolar-yngol,2001,258:451.

11 Debruyne F,Ostyn F,Delaere P,et al.Acoustic analysis ofthe speaking voice after thyroidectomy[J].J Voice,1997,11:479.

12 Scherer KR.Expression or emotionin voice and music[J].JVoice,1995,9:235.

13 Mupparapu M,Vuppalapati A.Ossification of laryngeal car-tilages on lateral cephalometric radiographs[J].Angle Orth-od,2005,75:196.

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甲状腺腺叶切除嗓音

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夏菲屈季宁李翠娥周涛