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

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。

Objective To investigate the characteristics of voice changes by multi-dimensional acoustic analysis in patients who underwent thyroid gland lobectomy without laryngeal nerve injury. Methods To observe vocal cord movement and evaluate voice quality, 32 patients with unilateral thyroid adenoma received the examinations of fiberlaryngscopy and Multi-Dimensional Voice Program before and after operation, respectively. Forty subjects with normal voice were used as cantrol group. Results Fiberlaryngscopy examinations were normal in all patients before and after surgery. In thyroid group, the preoperative acoustic parameters in male patients showed no significant difference（P〉0.05） compared with the control group. There was no significant difference between preoperative and postoperative acoustic parameters（P^0. 05）. While the postoperative acoustic parameters of female patients was significantly lower than those of preoperative and in control group（P〈0.05）. There was significant improvement 3 months after the operation compared with that of preoperative group（P〈0.05）. Fhi of 3 months after operation was still lower than those of preoperation and in control group in male and female patients that continues to be significant after 3 months. Conclusion Voice changes may occur after unilateral thyroid gland lobectomy without any laryngeal nerve injury, and there is little voice change in male patients,while in female patients, voice improvement is observed after operation. Fhi still remaines lower level for a certain of time.