■比较声带息肉的CO2激光切除术和喉显微手术,并为最佳手术方法提供证据。
■这是一项回顾性队列研究,包括2018年8月至2021年12月在我院接受CO2激光切除术或喉部显微手术的74例声带息肉患者。根据他们的喜好,77例患者分为两组:CO2激光切除组(n=35)和喉显微手术组(n=39)。手术前两天对患者进行了评估,进行了一次随访,手术后两周和四周。嗓音障碍指数(VHI-10)得分,收集每位患者的语音声学分析结果和电子喉镜检查结果,并评价两组之间的差异。
■74例患者的基本人口统计学特征具有可比性,所有患者均完成术后随访观察。CO2激光切除组共30例(85.71%),喉部显微手术组共22例(56.41%)患者全部愈合。CO2激光切除组总有效率(94.29%)明显高于喉显微手术组(82.05%),两组之间的差异有统计学意义(p=0.037)。两种手术方式对降低VHI-10评分均有积极作用,CO2激光切除效果更明显。两组在这方面的差异具有统计学意义(p<.001)。每种手术方法对平均基频扰动(抖动)的影响,振幅扰动(微光),最大发声时间和发音障碍严重程度指数无统计学意义(p>.05)。
■CO2激光切除术和喉部显微手术对语音质量的影响相似,但CO2激光切除具有较高的临床疗效。
To compare CO2 laser resection and laryngeal microsurgery for vocal cord polyps and provide evidence for the optimal surgical method.
This was a retrospective cohort study that included 74 patients with vocal cord polyps who underwent either CO2 laser resection or laryngeal microsurgery in our hospital from August 2018 to December 2021. According to their preference, 77 patients were divided into two groups: a CO2 laser resection group (n = 35) and a laryngeal microsurgery group (n = 39). Patients were evaluated two days before surgery, and follow-ups were conducted one, two and four weeks after surgery. The voice handicap index (VHI-10) score, voice acoustic analysis results and electronic laryngoscopy results were collected for each patient, and the differences between the two groups were evaluated.
The basic demographic characteristics of the 74 patients were comparable, and all patients completed postoperative follow-up observations. A total of 30 (85.71%) patients in the CO2 laser resection group and 22 (56.41%) patients in the laryngeal microsurgery group were healed. The total effectiveness rate of the CO2 laser resection group (94.29%) was significantly higher than that of the laryngeal microsurgery group (82.05%), and the difference between the two groups was statistically significant (p = .037). Both surgical methods had a positive effect on reducing VHI-10 scores with the effect of CO2 laser resection being more obvious. The difference between the two groups in this regard was statistically significant (p < .001). The effects of each surgical method on the average fundamental frequency perturbation (jitter), amplitude perturbation (shimmer), maximum phonation time and dysphonia severity index were not statistically significant (p > .05).
CO2 laser resection and laryngeal microsurgery have similar effects on voice quality, but CO2 laser resection has higher clinical efficacy.