声带轻瘫患者在年龄、性别和嗓音严重程度方面的患者选择趋势。

文献信息

中文摘要

目的： 耳鼻咽喉科学的进展提高了声带轻瘫与声带麻痹的鉴别能力。声带轻瘫的治疗包括嗓音治疗和手术干预，如注射填充或喉部手术。关于与初始治疗选择（嗓音治疗与手术治疗）趋势相关的患者特征数据有限。本研究旨在描述声带轻瘫患者治疗选择的趋势。
方法： 对150名临床诊断为“声带轻瘫”的成年患者进行了回顾性病历审查。收集的数据包括诊断时的年龄、性别、使用嗓音障碍指数-10（VHI-10）评估的嗓音严重程度以及治疗方式选择（不治疗、嗓音治疗或声带填充）。还收集了常见的合并症。根据VHI-10评分、年龄和性别在初次咨询时进行比较。
结果： 本研究包括76名女性和74名男性。关于严重程度，我们发现VHI-10评分每增加1个单位，不接受治疗的几率降低8%（显著性@0.000001），接受声带注射（VFI）的几率增加7%（显著性@0.0004）。年龄每增加1岁，不接受治疗的几率降低3%（显著性@0.0082），接受VFI的几率增加3%（显著性@0.0446）。在选择不治疗与治疗之间，性别无统计学显著性（P值=0.903）。未接受治疗的患者更可能没有主要合并症，而接受嗓音治疗或VFI的患者更常见至少有一种合并症。
结论： 本研究为描述声带轻瘫诊断后的患者治疗选择提供了客观数据。这些结果表明，诊断时的年龄和嗓音严重程度是与初始患者治疗选择相关的因素。

英文摘要

OBJECTIVES: Advances in otolaryngology have led to improved differentiation between vocal fold paresis and paralysis. Treatments for vocal fold paresis include voice therapy and surgical interventions, such as injection augmentation or laryngeal surgery. Limited data exist regarding patient profiles associated with trends in initial treatment selection of voice therapy versus surgical treatment. The purpose of this study was to describe trends in treatment selection for patients with vocal fold paresis.
METHODS: A retrospective chart review was conducted of 150 adult patients with a clinical diagnosis of "vocal fold paresis." Data collected included age at diagnosis, gender, voice severity assessed using the Voice Handicap Index-10 (VHI-10), and treatment modality options (no treatment, voice therapy, or vocal fold augmentation). Common comorbidities were also collected. Comparisons were made at the initial consultation according to VHI-10 score, age, and gender.
RESULTS: This study included 76 females and 74 males. For severity, we found that for every 1 unit increase in VHI-10 score, the odds of receiving no treatment decreased by 8% (sig @ 0.000001) and the odds of receiving vocal fold injection (VFI) increased by 7% (sig @ 0.0004). For every 1 unit of increase in age, the odds of receiving no treatment decreased by 3% (sig @ 0.0082) and the odds of receiving VFI increased by 3% (sig @ 0.0446). Gender was not statistically significant when choosing between no treatment and treatment (P-value = 0.903). Patients who did not receive treatment were more likely to have no major comorbidities, whereas those who received voice therapy or VFI more commonly had at least one.
CONCLUSIONS: This study provides objective data for describing patient treatment selection following the diagnosis of vocal fold paresis. These results suggest that age and voice severity at the time of diagnosis are factors associated with initial patient treatment selection.