非神经性甲状腺切除术后失声症:527名患者的长期语音结果
Jeong-Yeon Ji1, Seo Young Kim1, Joonsik Yoon1
1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, South Korea.
概括
甲状腺切除术后的声音变化即使没有神经损伤也可能发生. 虽然大多数语音问题在一年内就会解决,但年龄和手术程度等因素会影响非神经性甲状腺切除术后失声症的长期恢复.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 声音科学 声音科学
- 外科手术的结果
背景情况:
- 甲状腺切除术后的听力障碍 (PTD) 是常见的,但非神经原因的理解较少.
- 在神经功能保留的患者中评估长期语音结果对于全面的PTD特征是至关重要的.
研究的目的:
- 通过分析长期语音结果来表征非神经PTD.
- 在没有证据表明甲状腺切除术后神经损伤的患者中确定影响语音恢复的因素.
主要方法:
- 对527名甲状腺切除术后患者进行了回顾性队列研究,这些患者具有正常的声移动性和EMG.
- 在手术前和手术后的多个时间点进行全面的语音评估 (声学,空气动力学,VHI-10).
- 线性混合模型和机器学习用于评估语音变化的预测因素.
主要成果:
- 手术后基本频率 (F0) 和说话基本频率 (SFF) 立即下降,老年患者和高手术前F0患者的持续下降.
- 语音障碍指数-10 (VHI-10) 在全甲状腺切除术后早期增加,但在6-12个月后恢复到基线;年龄较大与VHI-10恢复延迟相关.
- 手术前F0和年龄预测F0/SFF,而手术程度预测VHI-10和1个月的最大频率 (Fmax).
结论:
- 在甲状腺切除术后,尽管保留了复发性喉神经和高级喉神经功能,但语音变化可能会发生.
- 大多数语音参数随着时间的推移而有所改善,但不能保证完全康复,受患者的性别,年龄,手术程度和手术前F0.0的影响.
- 调查结果有助于就非神经PTD和预期的语音结果向患者提供咨询.
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