甲状舌管囊肿术后嗓音分析

Voice analysis in patients after surgery of thyroglossal duct cyst

目的探讨甲状舌管囊肿(TDC)患者手术前后的嗓音变化特点。方法选取2018年1月—2019年12月行TDC切除术的患者49例为研究对象,其中男24例,女25例,年龄为22~65岁,平均年龄为(41.55±11.78)岁。对患者术前,术后1周及术后6个月分别行嗓音障碍指数(VHI)和GRBAS的主观评估、嗓音声学分析的客观检测以及频闪喉镜检查,比较手术前后的评估结果。结果①VHI的评估:女性患者的情感(E)评分在术后1周较术前显著性差异(P<0.05),术后6个月与术前差异不明显,而其功能(F)和生理(P)评分较术前无明显差异;男性患者手术前后的VHI各评分均无显著性差异;②GRBAS的评估:女性患者的气息度(B)和无力度(A)评分在术后1周较术前差异显著(P<0.05),术后6个月同术前差异不大,而其总分(G),粗糙度(R)和紧张度(S)评分无显著性差异;男性患者手术前后的GRBAS各评分均无显著性差异;③嗓音声学分析:男性及女性患者的基频(F0)和最长发声时间(MPT)在术后1周均较术前差异显著(P<0.05),术后6个月同术前差异不明显;而其基频微扰(jitter)和振幅微扰(shimmer)无显著性差异。结论TDC患者手术后会出现嗓音评估指标的一过性改变,及早行嗓音评估、发音训练或心理干预,有利于患者的嗓音康复。

Objective To investigate the changes of voice quality in patients after surgery of thyroglossal duct cyst(TDC).Methods Forty-nine patients(24 males and 25 females)undergoing surgery of TDC from Jan 2018 to Dec 2019 were included.Their age ranged from 22 to 65 years old with an average of(41.55±11.78).Before surgery and one week as well as 6 months after surgery,subjective evaluations including voice handicap index(VHI)and GRBAS,objective evaluation of acoustic analysis as well as stroboscopic laryngoscopy were performed in all patients.The pre-and postoperative results were compared.Results①The evaluations of VHI showed significant difference between preoperative and one week post-operative emotional(E)scores in female patients(P<0.05),and insignificant difference between the preoperative and 6 months post-operative ones.The evaluations revealed that their differences between the preoperative and post-operative functional(F)scores as well as physiological(P)scores were both insignificant.Meanwhile,the differences between preoperative and post-operative VHI scores in male patients were all insignificant.②The evaluations of GRBAS showed that the preoperative scores of breathiness(B)and asthenia(A)were significantly different from those of one week after operation in female patients(both P<0.05),and their differences between the preoperative and 6 months after operation were insignificant.The evaluations revealed insignificant differences between their preoperative grade(G),roughness(R)as well as strain(S)scores and the postoperative ones.There were no significant differences between the pre-and postoperative GRBAS scores in male patients.③Acoustic analysis of voice demonstrated that the preoperative fundamental frequency(F0)and maximum phonation time(MPT)in both male and female patients were significantly different from those of one week after operation(all P<0.05),but the differences between the preoperative and 6 months after operation were insignificant.The differences between pre-and postoperative jitter and shimmer in both male and female patients were insignificant.Conclusion Patients with TDC may have transient changes in voice evaluation after operation.Voice evaluation,speech training or psychological intervention as soon as possible are beneficial to their voice rehabilitation.