手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效分析

The Effects of Phonosurgery Combined with Voice Therapy for Vocal Polyps Accompanied with Muscle Tension Dysphonia

目的探讨手术联合嗓音训练对伴肌紧张性发声障碍声带息肉患者的疗效。方法 117例伴肌紧张性发声障碍的声带息肉患者分为单纯手术组(手术组,57例)和手术联合嗓音训练组(联合组,60例),另随机选取50例无嗓音疾患的正常人作为正常对照组。采用Xion声学分析软件对正常对照组及手术组、联合组患者治疗前后的嗓音基频微扰(jitter)、振幅微扰(shimmer)、嗓音障碍指数(DSI)进行测试并比较。结果手术组、联合组治疗后jitter和shimmer值均较治疗前明显降低,DSI明显升高(P<0.05),而联合组的jitter和shimmer值更低,DSI值更高(P<0.05);手术组治疗后的jitter和shimmer值高于正常组,DSI值低于正常组(P<0.05);联合组治疗后jitter和shimmer与正常组比较差异无统计学意义(P>0.05)。结论喉显微外科手术联合嗓音训练有助于提高伴肌紧张性发声障碍声带息肉患者手术后的嗓音质量。

Objective To evaluate the effects of phonosurgery combined with voice therapy in patients with vocal polyps accompanied with muscle tension dysphonia（MTD）.Methods The study retrospectively enrolled 117 patients with a diagnosis of vocal polyps accompanied with MTD.All the patients were divided into two groups according to the different remedies：the surgery group（n=57）,and the combination group（n=60）.The Xion acoustic analysis was carried out on the two groups before and after therapy.We compared the results in each group,the results of post-therapy between two groups,and that of post-therapy with the control group（n=50）.The acoustic parameters were jitter percent（jitter）,shimmer percent（shimmer）,dysphonia severity index（DSI）.ResultsThe results obtained in the study showed that all the voice analysis parameters were significantly improved after therapy in both the surgery group and combination group（P〈0.05）.Jitter and shimmer in post-therapeutic outcome of the combination group were lower than those of in surgery group,and DSI was even higher（P〈0.05）.Jitter and shimmer in post-therapeutic outcome of surgery group were higher than those of in normal group,and DSI was lower than those of in normal group（P〈0.05）.But there were no clinically significant differences in posttherapeutic outcomes of combination group compared with control group（P〉0.05）.Conclusion As for vocal polyps accompanied with MTD,successful phonosurgical treatment and voice therapy can improve patients＇ voice quality.