目的:研究经口CO2激光显微手术(TLM)患者术后嗓音质量随年龄的变化。
方法:前瞻性招募接受I至VI型TLM和术后言语治疗的患者。语音质量是预先评估的,1-,3-6-和12个月的治疗后语音障碍指数(VHI),发音困难,粗糙度,呼吸,虚弱,应变(GRBAS),最大发声时间(MPT),F0,F0标准偏差(STD),百分比抖动,微光百分比,噪声谐波比(NHR),声带振动评估和语音流畅性。考虑患者年龄,分析了嗓音结果的演变(<60vs.≥60岁)。
结果:75名患者完成了评估。34例和41例患者<60岁或≥60岁,分别。主客观语音参数(VHI,G,R,B),在<60岁的个体中,从TLM后1到6个月,抖动和流畅度显着改善。在≥60yo组中,TLM后12个月的语音参数有所改善,但VHI在TLM后3个月有所改善。年龄和12个月NHR之间存在正相关,G和A参数。
结论:术后语音质量参数的演变可能因患者年龄而异。术前VHI可预测12个月的主观和客观语音结果。
OBJECTIVE: To study the post-operative evolution of voice quality of patients treated by transoral CO2 laser microsurgery (TLM) according to the age.
METHODS: Patients treated by type I to VI TLM and post-operative speech therapy were prospectively recruited from our hospital. The voice quality was assessed pre-, 1-, 3- 6- and 12-month posttreatment with voice handicap index (VHI), dysphonia, roughness, breathiness, asthenia, strain (GRBAS), maximal phonation time (MPT), F0, F0 standard deviation (STD), percent jitter, percent shimmer, noise-to-harmonic ratio (NHR), vocal fold vibration assessment and speech fluency. Evolution of voice outcomes was analyzed considering age of patients (< 60 vs. ≥ 60 years).
RESULTS: Seventy-five patients completed the evaluations. Thirty-four and forty-one patients were < 60 or ≥ 60 yo, respectively. Subjective and objective voice parameters (VHI, G, R, B), jitter and fluency significantly improved from 1- to 6-month post-TLM in < 60 yo individuals. The voice parameters improved 12-month post-TLM in the ≥ 60 yo group at the exception of VHI that improved 3-month post-TLM. There were positive associations between age and 12-month NHR, G and A parameters.
CONCLUSIONS: The post-operative evolution of voice quality parameters may vary between patients according to the age. Preoperative VHI is predictive of 12-month subjective and objective voice outcomes.