不做气管切开的改良额侧位喉部分切除术后嗓音声学分析

The voice analysis in patients with laryngeal carcinoma underwent modified frontolateral partial laryngectomy without tracheotomy

目的探讨不同术式喉部分切除术后嗓音声学的差异。方法对24例改良额侧位喉部分切除术(A组)、18例传统喉垂直部分切除术(B组)和15例正常成年男性(C组)采用DIVAS嗓音分析系统行嗓音声学分析。电子纤维喉镜检查受试者术后声门恢复情况。结果 A、B组患者术后基频和谐噪比均低于C组,基频微扰、振幅微扰和标准化噪声能量均高于C组(P<0.05);而A、B两组的上述指标无统计学差异(P>0.05)。A组患者术后6个月声带前联合靠拢,声门恢复到近似三角形。结论改良额侧位喉部分切除术后的嗓音质量差于正常人,但可以避免气管切开。

Objective To investigate the voice acoustic difference after different types of surgery for laryngeal carcinoma. Methods With computer multimedia program of DIVAS, the voice acoustic analysis was performed in 24 cases with laryngeal carcinoma underwent modified frontolateral partial laryngectomy without tracheotomy（group A）, 18 cases with laryngeal carcinoma underwent conventional vertical partial laryngectomy with tracheotomy（group B） and 15 healthy adult males （group C）. The recovery of the glottis was observed by laryngoscopy. Results The fundamental frequency and harmonic to noise ratio were lower, but the jitter, shimmer and normalized noise energy were higher, in groups of A and B than those in group C（P〈0. 05）, which were not significantly different between groups of A and B（P〈0, 05）. The morphology of the glottis was changed from the initial approximate trapezoid to approximate a triangle in shape after six months. Conclusion The modified frontolateral partial laryngectomy without tracheotomy has a similar vocal quality as that after conventional vertical partial laryngectomy with traeheotomy in the patients with laryngeal carcinoma.