单侧声带麻痹患者以嗓音训练为主的非手术治疗的疗效及其影响因素

Analysis of the efficacy of non-surgical treatment mainly focus on voice therapy and it's influencing factors in patients with unilateral vocal fold paralysis

目的:回顾性分析嗓音治疗为主的非手术治疗对单侧声带麻痹患者的疗效及其影响因素。方法:对2021年8月-2023年8月以声嘶为主诉就诊于厦门大学附属中山医院嗓音科,并确诊为单侧声带麻痹的57例患者的临床资料进行回顾分析,通过声学、空气动力学、喉镜参数的变化来判断以嗓音训练为主的非手术治疗的效果,分析患者的年龄、性别、病程以及神经损伤的病因、类型、侧别与非手术治疗效果之间的关系。结果:对患者进行以嗓音治疗为主的非手术治疗后,患者的声带弓形程度、声门缝隙面积、声门上挤压程度、响度、基频微扰(Jitter)、振幅微扰(Shimmer)、不规则度(irregularity component,IC)、气息声(noise component,NC)参数上的改变差异有统计学意义(P<0.01);病程时间与声门缝隙面积、Shimmer及IC的改变具有弱相关(0.2<|r|<0.4)且相关性有统计学意义(P<0.05),声门缝隙面积与NC参数的改变在不同侧别的神经损伤样本上的差异有统计学意义(P<0.05)。结论:以嗓音治疗为主的非手术治疗对单侧声带麻痹患者具有良好的治疗效果,病程时间以及神经损伤的侧别可能影响治疗效果。

Objective Retrospective analysis of the efficacy and it's influencing factors of non-surgical treatment mainly focus on voice therapy for patients with unilateral vocal fold paralysis.Methods The retrospective study includes 57 patients who were diagnosed with unilateral vocal fold paralysis and presented with hoarseness as their main complaint at the Department of Voice Medicine,Zhongshan Hospital of Xiamen University from August,2021 to August,2023.Judging the efficacy of non-surgical treatment mainly focus on voice therapy through changes in acoustic,aerodynamic,and laryngoscopic parameters;Analyze the relationship between patients'age,gender,duration of disease,cause of nerve injury,type of nerve injury,side of nerve injury and efficacy of non-surgical treatment.Results After non-surgical treatment mainly focused on voice therapy,there were statistically significant differences(P<0.01)in the changes of vocal fold bow,glottal gap,glottal compression,loudness,Jitter,Shimmer,IC,and NC parameters.There is a statistically significant correlation between the duration of the disease and changes in glottal gap,Shimmer,and IC(P<0.05),the side of nerve injury can affect changes of glottal gap and NC(P<0.05).Conclusion Non-surgical treatment mainly focused on voice therapy has a good efficacy on patients with unilateral vocal fold paralysis.The duration of the disease and the side of nerve injury may affect the efficacy.