空气动力学测量在声带增强术疗效中的临床效用
Clinical Utility of Aerodynamic Measures in Vocal Fold Augmentation Outcomes.
文献信息
| PMID | 42864244 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kelly Zdrowak |
| 作者单位 | Department of Otolaryngology Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia. |
| 期刊 | Journal of voice : official journal of the Voice Foundation |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 声门功能不全可导致呼吸-喉功能障碍，进而引起发声困难。仪器评估可补充患者和临床医生报告的评价。空气动力学测量提供定量数据以表征发声功能。本研究旨在确定术前发声空气动力学测量是否与声门功能不全声带内移术后的疗效相关。
方法： 对2022年至2024年在埃默里嗓音中心接受注射喉成形术或1型甲状软骨成形术的患者进行回顾性分析，评估基线和术后发声空气动力学测量（发声时平均气流[MADV]）、说话时呼吸次数、说话持续时间以及患者报告结局（嗓音障碍指数-10），以评估手术前后的变化（N=98）。患者接受了一次或多次手术，但数据未按手术类型或顺序分层。
结果： 接受第二次增强手术的患者基线MADV显著更高（M=0.49 L/s，SD=0.25），而仅接受一次手术的患者为（M=0.32 L/s，SD=0.23；P=0.01），并且与单次手术队列相比，从基线（M=13.1，SD=7.2）到术后1（M=9.9，SD=4.5；P=0.02）朗读标准段落时呼吸次数更少。在各组中，VHI-10评分从基线（M=29.9，SD=8.7）到术后1（M=21.6，SD=10.7；P=0.0008）有所改善，第二次手术后进一步改善（M=10.9，SD=10.5；P=0.02）。
结论： 较高的基线MADV与需要多次手术相关，提示其可能有助于预测达到声门充分闭合所需的手术次数。治疗后气流和说话时呼吸次数的改善凸显了空气动力学评估在规划和评估干预结局中的临床价值。
证据等级： III级。
英文摘要
OBJECTIVE: Glottic insufficiency can result in respiratory-laryngeal dysfunction that contributes to dysphonia. Instrumental assessments complement patient- and clinician-reported evaluations. Aerodynamic measurements provide quantitative data to characterize phonatory function. This study aimed to determine whether preoperative phonatory aerodynamic measures are associated with outcomes following vocal fold medialization for glottic insufficiency.
METHODS: A retrospective review of patients who underwent injection laryngoplasty or type 1 thyroplasty at the Emory Voice Center from 2022 to 2024 was analyzed for baseline and postprocedure phonatory aerodynamic measures (mean airflow during voicing [MADV]), breaths while speaking, speaking duration, and patient-reported outcomes (voice handicap index-10) to assess changes across procedures (N = 98). Patients underwent one or multiple procedures, but data were not stratified by type or sequence.
RESULTS: Patients who underwent a second augmentation procedure had significantly higher baseline MADV (M = 0.49 L/s, SD = 0.25) than those who had one procedure (M = 0.32 L/s, SD = 0.23; P = 0.01), and took fewer breaths to read a standard passage from baseline (M = 13.1, SD = 7.2) to post-procedure 1 (M = 9.9, SD = 4.5; P = 0.02) than the 1-procedure cohort. Across groups, VHI-10 scores improved from baseline (M = 29.9, SD = 8.7) to postprocedure 1 (M = 21.6, SD = 10.7; P = 0.0008), and further after procedure 2 (M = 10.9, SD = 10.5; P = 0.02).
CONCLUSION: Higher baseline MADV was linked to requiring multiple procedures, suggesting it may help predict the number needed to achieve glottic sufficiency. Post-treatment improvements in airflow and the number of breaths while speaking highlight the clinical value of aerodynamic assessments in planning and evaluating intervention outcomes.
LEVEL OF EVIDENCE: Level III.