Vocal function after transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancer
Vocal function after transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancer
复制标题
下咽癌和声门上癌经口电视喉镜手术 (TOVS) 后的发声功能
DOI：
10.1080/00016489.2016.1266509
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Shiotani A.
中科院分区：
文献类型：
--
作者：
Tanaka S;Tomifuji M;Araki K;Uno K;Tanaka Y;Mizokami D;Suzuki H;Miyagawa Y;Taniai S;Shiotani A.
结论：梨状窝内外侧切除与TOVS术后发音障碍有关。环杓关节周围的瘢痕挛缩导致杓状软骨向外侧位置固定，并且这种伤口愈合过程导致声门闭合不充分。虽然TOVS的肿瘤和功能的结果是令人满意的，外科医生应该提到的风险，术后语音障碍的术前counselling.Objectives：经口手术是一种微创治疗下咽癌和声门上癌的选择。术后发音功能是令人满意的，在大多数情况下，但在某些情况下，声带是固定的，偶尔语音障碍stills.Methods：55例患者接受经口视频喉镜手术（TOVS）下咽癌和声门上癌的发音功能进行了评估GRBAS感知量表，空气动力学测试和声学分析，和语音障碍指数问卷。结果：16例（29.1%）患者存在语音障碍（G评分≥ 2）。单变量分析显示，内外侧梨状窦切除术（p= 0.0018）和颈淋巴结清扫术（p= 0.0421）与术后语音障碍相关。多变量分析显示内外侧梨状窝切除术（p= 0.0021）与术后语音障碍相关。
Conclusion:The resection of the medial and lateral pyriform sinus was associated with post-operative voice impairment after TOVS. Scar contracture around the cricoarytenoid joint lead to arytenoid fixation toward lateral position, and this wound healing process caused insufficient glottis closure. Although oncological and functional outcomes of TOVS was satisfactory, surgeons should mention the risk of post-operative voice impairment in pre-operative counseling.Objectives:Transoral surgery is a minimally invasive treatment option for hypopharyngeal and supraglottic cancer. Post-operative vocal function was satisfactory in most cases, but in some cases vocal cord was fixed and occasionally voice impairment persists.Methods:Vocal function of 55 patients who underwent transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancers was evaluated by the GRBAS perceptive scale, aerodynamic tests and acoustic analyses, and the Voice Handicap Index questionnaire. The risk factors for voice impairment were identified.Results:Voice impairment (G score ≧2) was found in 16 cases (29.1%). Univariate analysis revealed that the resection of medial and lateral pyriform sinus (p= .0018) and neck dissection (p= .0421) were associated with post-operative voice impairment. Multivariate analysis revealed that the resection of medial and lateral pyriform sinus (p= .0021) was associated with post-operative voice impairment.