早期喉癌等离子消融术后的嗓音评价

Voice evaluation after coblation for early glottic carcinoma

目的评价经支撑喉镜等离子消融术治疗的早期声门型喉癌术后嗓音的康复情况。方法 2014年1月~2016年9月在我院就诊的42例早期声门型喉癌患者,经支撑喉镜内镜辅助下行喉部肿瘤等离子消融切除术,手术前及术后3、6、9及12个月应用嗓音障碍指数VHI-10、RBH听感知评估及Praat嗓音分析对患者嗓音进行主客观评估。结果所有患者随访12个月以上,嗓音评估显示术后3个月嗓音质量明显下降,6个月后逐渐好转,9~12个月后,除气息声和基频以外其他嗓音评估参数均较术前提高(P均<0.05)。其中T1a级患者术后嗓音客观参数均较T1b及T2级恢复更好(P均<0.05)。结论经支撑喉镜等离子消融切除术治疗早期喉癌术后嗓音功能恢复较好。

OBJECTIVE To evaluate the voice outcome after endoscopic laryngeal surgery with plasma radiofrequency ablation for early glottic cancer. METHODS Forty-two patients with early glottic squamous cell cancer accepted resection of laryngeal cancer lesions using transoral endoscopic coblation from February 2014 to September 2016 in our hospital. Voice analysis was performed before and after operation（3 months, 6 months, 9 months and 12 months after operation）. Subjective voice analysis（Voice Handicap Index-10 and RBH voice perceptual evaluation） and objective acoustic voice analysis（fundamental frequency, fundamental frequency perturbation, amplitude perturbation, harmonic noise ratio） using the Praat program were conducted. RESULTS With following-up of over 12 months, voice quality deteriorated with in the 3 months after operation, and gradually improved at the 6 months after operation. Except breathiness scores and fundamental frequency, the most parameters became better at the 9-12 months after operation than that before operation（P〈0.05）. The objective parameters of voice in patients with stage T1 a were better than those in stage T1 b and stage T2（P〈0.05）. CONCLUSION The laryngeal endoscopic surgery with plasma radiofrequency ablation has therapeutic effect for early glottis cancer, and the voice quality gradually improved over time after operation.