CO_2激光和喉微瓣手术治疗声带囊肿短期嗓音声学分析比较

Analysis of CO_2 laser and conventional laryngomicrosurgery treatments for vocal cord cyst:an evaluation of short-term voice acoustics outcomes

目的:探讨CO_2激光和喉微瓣手术治疗声带囊肿手术前后(短期)的嗓音声学参数改变。方法:60例声带囊肿患者随机分为CO_2激光组和喉微瓣组,每组30例,CO_2激光组采用CO_2激光治疗,喉微瓣组采用外侧瓣或内侧微瓣技术。对2组术前与术后1周、1个月、3个月的嗓音声学参数进行分析。结果:与术前比较,术后1周CO_2激光组基频微扰(Jitter)、振幅微扰(Shimmer)和谐噪比(HNR)差异均无统计学意义(P>0.05),而总嘶哑度(G)和嗓音障碍指数量表(VHI-10)与喉微瓣组比较差异有统计学意义(P<0.05),喉微瓣组HNR比较差异有统计学意义(P<0.05);术后1～3个月,CO_2激光组Jitter、Shimmer和HNR差异均有统计学意义(P<0.05),与喉微瓣组比较差异亦有统计学意义(P<0.05),G和VHI-10与微瓣组比较差异无统计学意义(P>0.05)。结论:CO_2激光喉显微手术治疗声带囊肿,可显著改善声带形态和发声质量,较常规手术更有效。

Objective:To compare the short-term outcomes of CO2 laser and conventional laryngeal microsurgery for vocal cord cyst.Method:Patients with vocal cord cyst were divided randomly into two groups.One group was treated with CO2 laser(laser group)and the other underwent Micro-flap surgery(Micro-flap group).For the objective assessment,Amulti-dimensional voice program module for voice spectrum analysis was used.Result:In the laser group,there were no significant differences between the preoperative and 1 week postoperative parameters of Jitter,Shimmer and HNR(P>0.05).However,the parameters of G and VHI-10 were significantly different between the laser group and Micro-flap group(P<0.05).The objective data of the laser group pre-and postsurgery showed that the voice recovery of the laser group was significantly better than that of the Micro-flap group after 1 to 3 months of follow-up(P<0.05).But no significant differences of the parameters of G and VHI-10 was noted between the laser group and Micro-flap group(P>0.05).Conclusion:CO2 laser laryngeal microsurgery for vocal cord cyst can significantly improve pronunciation quality.