METHODS: A prospective study was conducted. Voice audio recordings were obtained at 4 moments; 1. direct prior to the start of surgery, 2. during surgery after medialisation thyroplasty, 3. during surgery after medialisation and arytenoid adduction, 3 months postoperative. At these same timepoints patients rated their own voice on a numeric rating scale between 0 and 10. The blinded recordings were rated by consensus in a team of experienced listeners, using the Grade of the GRBAS scale. Furthermore, the Voice Handicap Index was administered before and at 3 months after surgery.
RESULTS: Ten patients who underwent medialisation and arytenoid adduction at our tertiary referral hospital between 2021 and 2022, were included. One patient was excluded after surgery. The intraoperative measurements showed a Grade score of 1.4 preoperatively, improving to 1.2 after medialisation, 1.2 after medialisation and arytenoid adduction, and further improving to 0.4 at 3 months postoperative, which was a not statistically significant improvement (p = 0.2). The intraoperative subjective numeric rating scale showed a statistically significant improvement from 3.9 preoperatively, to 6.1 after medialisation, 7.1 after medialisation and arytenoid adduction and a 7.6 at 3 months postoperative (p = 0.001). The Voice Handicap Index total score showed a statistically significant improvement from 71 points before surgery to 13 at 3 months after surgery (p = 0.008).
CONCLUSIONS: Our study using intraoperative voice measurements indicate that the addition of arytenoid adduction to medialisation thyroplasty is a benefit in selected patients although more studies are needed due to the many limitations inherent to this field of investigation.
方法:进行前瞻性研究。在4时刻获得语音录音;1.在手术开始之前,2.在甲状腺中介成形术后的手术过程中,3.在手术后的中介和arytenoid内收,术后3个月。在这些相同的时间点,患者在0到10之间的数字评定量表上对自己的声音进行评分。盲目的录音在一组经验丰富的听众中得到了一致的评价,使用GRBAS量表的等级。此外,在手术前和手术后3个月时使用语音障碍指数.
结果:纳入了在2021年至2022年期间在我们的三级转诊医院接受了中介化和Arytenoid内收的10例患者。一名患者在手术后被排除在外。术中测量显示术前评分为1.4,调解后提高到1.2,1.2在中介化和arytenoid内收之后,术后3个月进一步改善至0.4,无统计学意义的改善(p=0.2)。术中主观数字评定量表显示与术前3.9相比有统计学上的显着改善,到6.1,在调解后,7.1个月后,在3个月后为7.6(p=0.001)。语音障碍指数总分显示,从手术前的71分到手术后3个月的13分,具有统计学意义(p=0.008)。
结论:我们使用术中语音测量进行的研究表明,尽管由于该研究领域固有的许多局限性,需要进行更多的研究,但在选定的患者中,在中介甲状腺成形术中添加类软骨内收是有益的。