Vocal function following radiation for non-laryngeal versus laryngeal tumors of the head and neck
Vocal function following radiation for non-laryngeal versus laryngeal tumors of the head and neck
复制标题
DOI：
10.1097/00005537-200111000-00009
复制
发表时间：
2001-11-01
期刊：
影响因子：
2.6
通讯作者：
Venkatesan, VM
中科院分区：
文献类型：
--
作者：
Fung, K;Yoo, J;Venkatesan, VM
客观的。即使没有疾病，喉部也可能接受高剂量的辐射。初步调查提供的证据表明，接受头颈部非喉部肿瘤放射治疗（RT）的患者存在明显的声音改变。本研究评估了该患者群体的发声功能的主观和客观参数，并与接受早期声门肿瘤放射治疗的对照组患者进行比较。研究设计：回顾性队列研究。方法：对接受非喉部和早期声门肿瘤放射治疗的患者的声带功能进行全面评估和比较。对元音产生数据进行了微观分析和宏观分析声学分析、空气动力学测量和视频频闪检查。语音障碍指数用于语音质量的自我评估。所有受试者均为男性、吸烟者且 RT 后 12 个月以上。结果：对 17 名非喉肿瘤患者和 13 名早期声门肿瘤患者进行了评估。非喉组中 75%（8 项中的 6 项）元音产生的声学测量的微分析声学参数较差。这些包括抖动、相对幅度扰动、幅度扰动商、归一化噪声能量、音调幅度和频谱平坦度。宏观声学分析显示，非喉组的基频没有差异，但语音频率范围在数值上较小。非喉组的所有空气动力学指标，包括平均发声时间、平均气流和声带介电动力学速率均有所下降。视频频闪镜检查显示非喉组的声门上活动增加。非喉组的声音障碍明显更大。结论：与接受早期声门肿瘤放疗的患者相比，接受广域放疗的非喉部肿瘤患者存在发声功能障碍的客观和主观证据。
Objective. The larynx may receive high doses of radiation even in the absence of disease. Preliminary investigation has provided evidence that significant voice alterations exist in patients who received radiotherapy (RT) for non-laryngeal tumors of the head and neck. This study evaluates subjective and objective parameters of vocal function in this patient population compared with a control group of patients irradiated for early glottic tumors. Study Design: Retrospective cohort study. Methods: Vocal function in patients irradiated for non-laryngeal and early glottic tumors was assessed in a comprehensive manner and compared. Microanalytical and macroanalytical acoustic analyses, aerodynamic measurements, and videostroboscopy were performed on vowel production data. The Voice Handicap Index was administered for self-assessment of voice quality. All subjects were male, smokers, and greater than 12 months post-RT. Results: Seventeen patients with non-laryngeal tumors and 13 patients with early glottic tumors were evaluated. Microanalytical acoustic parameters were worse for 75% (6 of 8) of the acoustic measures of vowel production in the non-laryngeal group. These include jitter, relative amplitude perturbation, amplitude perturbation quotient, normalized noise energy, pitch amplitude, and spectral flatness ratio. Macroanalytical acoustic analyses revealed no difference in fundamental frequency but numerically smaller phonational frequency range in the non-laryngeal group. All aerodynamic measures, including mean phonation time, mean airflow, and vocal fold diadochokinetic rate, were decreased in the non-laryngeal group. Videostroboscopy demonstrated increased supraglottic activity in the non-laryngeal group. Voice handicap was significantly greater in the nonlaryngeal group. Conclusions: When compared with patients receiving RT for early glottic tumors, there is objective and subjective evidence of vocal dysfunction in patients treated with wide-field RT for nonlaryngeal tumors.