喉良性增生性病变的嗓音学特点及治疗转归.pdfVIP

526 JClinOtorhinolaryngol(China),Sep2004,Vol18,No9 喉良性增生性病变的嗓音学特点及治疗转归 ‘ 徐文’韩德民 ‘侯丽珍， 张丽 ‘叶京英 ‘王军 ‘ 〔摘要」 目的:探讨喉良性增生性病变对发声功能的影响及CO:激光显微外科术后的转归特点。方法:对 292例喉良性增生性病变患者(声带息肉、任克水肿、声带小结、囊肿、慢性肥厚性喉炎)的流行病学、嗓音声学、形 态及C02激光显微外科术后转归进行分析。结果:声带小结患者均为青年女性，23.08%与职业有关;任克水肿 为中老年患者。声带息肉及小结病变局限，手术仅涉及声带局部，术后改善明显，术后1个月达正常状态;任克水 肿患者术后 1个月改善明显，术后3个月恢复最佳稳定;声带囊肿患者术后 1个月声音达最佳状态，但由于病变 切除术后局部存在缺损，一定程度上影响预后;慢性肥厚性喉炎患者术后改善不满意。术后声门上代偿纠正均不 明显。结论:喉良性增生性病变主要累及声带被菠层，嗓音声障碍的程度及疗效与受累范围有关，激光显微外科 手术可以保留良好结构及功能。除外科治疗外，还应及时矫正不良发声习惯等因素，以期获得最佳疗效。 【关键词〕喉良性增生性病变;声学;言语参数测量;激光手术;显微外科手术 [中图分类号〕R767.1 [文献标识码] A [文章编号〕 1001-1781(2004)09-0526-04 Vocalfunctionofbenignvocalfoldlesionsandoutcomes assessmentafterC02phonomicrosurgery XUWen HANDemin HOULizhen ZHANGLiYEJingying WANGJun (DepartmentofOtorhinolaryngology,BeijingTongrenHospital，CapitalUniversityofMedical Sciences，Beijing，100730，China) AbstractObjective:Toinvestigatethenatureofbenignvocalfoldlesionsanditsoutcomesassessmentafter C02phonomicrosurgery.Method:Vocalfunctionof292casesofbenignvocalfoldlesions(vocalnodules,Reinkes edema,vocalfoldcyst,vocalfoldpolypandchroniclaryngitis)andtheiroutcomesassessmentafterC02phonomi- crosurgerywereevaluated.Vocalfunctionwasexaminedbyacousticanalysis,aerodynamicanalysisandvideostro- boscopicexamination.Result:Youngwomenwithprofessionaloccupationwerepredominantinvocalnodulesand thehigherageshoweredinReinkesedema.Vocalfunctionofvocalnodulesandvocalfoldpolypshadimproved distinctlyonlyonemonthafteroperation.ForReinkesedema,vocalfunctioncanrecoverthreemonthsafteropera- tionsteadily.Althoughvocalfunctionofvocalcystalsohadimproveddistinctlyonlyonemonthafteroperation, therewasdepressioninsteadofcyst,theoutcomeofvocalqualitywouldbeaffectedbythat.Vocalfunctionofchro- niclaryngitis