背景:声带沟(SV)是一种声音障碍,其特征是粘附在声带韧带上的声带上皮平行内陷。这种情况破坏了振动功能,导致声门无能,声音嘶哑,和声带损伤。尽管提出了各种手术技术,标准化的治疗方法仍然难以捉摸。
方法:我们对PubMed/Medline进行了全面搜索,Embase,WebofScience,学者,和Cochrane图书馆进行SV治疗的研究。纳入标准包括比较SV患者治疗前和治疗后声乐结果的原始研究,用英语出版。我们排除了病例报告,reviews,没有连续数据的研究,和声带疤痕/萎缩的患者。
结果:共纳入15项观察性研究(361例患者,53.73%男性,平均年龄41.64岁)。这些研究中有80%采用了自我报告的结果,而81.25%的人分析了声学/空气动力学数据。随访时间为4至44个月。所有技术均显着提高了语音障碍指数(VHI)得分(p<0.001)。解剖和联合技术显示VHI-30/10的降低更大(p<0.001)。在所有技术中,最大语音时间(MPT)显着提高(p<0.001),解剖技术显示出更好的MPT结果(p<0.001)。对于解剖和射入技术,抖动显著改善(p<0.001),所有技术的Shimmer也是如此(p<0.001)。值得注意的是,联合技术显示最显著的降低(p<0.001).
结论:手术治疗显著改善主观性,空气动力学,SV患者的声学结果。与单独的射入技术相比,解剖和组合的解剖/射入技术似乎可以产生更好的感知和发声结果。需要进一步研究以建立SV的最佳治疗方法。
BACKGROUND: Sulcus Vocalis (SV) is a voice disorder characterized by the parallel invagination of the vocal fold epithelium that adheres to the vocal ligament. This condition disrupts the vibratory function, leading to glottal incompetence, hoarseness, and vocal impairment. Despite various proposed surgical techniques, a standardized treatment approach remains elusive.
METHODS: We conducted a comprehensive search across PubMed/Medline, Embase, Web of Science, Scholar, and the Cochrane Library for studies on SV treatment. The inclusion criteria comprised original studies comparing pre- and post-treatment vocal outcomes in SV patients, published in English. We excluded case reports, reviews, studies without continuous data, and patients with vocal scar/atrophy.
RESULTS: Fifteen observational studies were included (361 patients, 53.73 % male, average age 41.64 years). 80 % of these studies employed self-reported outcomes, while 81.25 % analyzed acoustic/aerodynamic data. The follow-up period varied from 4 to 44 months. All techniques significantly improved Voice Handicap Index (VHI) scores (p < 0.001). Dissective and combined techniques exhibited greater reductions in VHI-30/10 (p < 0.001). Maximum Phonation Time (MPT) improved significantly across all techniques (p < 0.001), with dissective techniques demonstrating superior MPT outcomes (p < 0.001). Jitter improved significantly for dissective and injective techniques (p < 0.001), as did Shimmer for all techniques (p < 0.001). Notably, combined techniques displayed the most significant reductions (p < 0.001).
CONCLUSIONS: Surgical treatments significantly improve subjective, aerodynamic, and acoustic outcomes in SV patients. Dissective and combined dissective/injective techniques appear to yield better perceptual and phonatory outcomes compared to injective techniques alone. Further research is necessary to establish the optimal treatment approach for SV.