声带注射治疗声带麻痹及检测喉发音的研究

对30例不同病因所致单侧声带麻痹患者,采用经环甲间隙穿刺声带注射硅胶的方法进行治疗.治疗前后对患者的最长发音时间(MPT)、喉平均呼气流率(MFR)、基频值(F_0)、声强级(SPL)、频率微扰商(PPQ)、振幅微扰商(APQ)、噪声能量级(NNE),频闪喉镜下声带振动发音过程中的对称性(SYM)、规则性(REG)、振幅(AMP)、闭合状态(GLO)、粘膜波动(MUC)、等质性(NON)和嗓音心理听觉评价参数:音哑总分度(G)、粗糙型(R)、气息型(B)、无力型(A)、紧张型(S)进行检测,并对测试结果进行统计学分析.实验结果表明,上述各项参数值在治疗后较治疗前有明显改善,其中MPT、GLO值的增高,MFR、PPQ、APQ、NNE值下降表现最明显:心理听觉评价参数GRBAS值治疗后较治疗前也有明显好转.对各参数进行统计学分析得出:声带麻痹嗓音中噪音成分主要同声带振动的规则性、振幅和粘膜波呈正相关(P<0.05或 P<0.01).声带麻痹嗓音的主观心理听觉评价是以气息型和无力型为主.它主要与喉平均呼气流率,声带振动的规则性、闭合度、振幅、声带粘膜波及对称性呈正相关.从而证明,经环甲间隙声带注射硅胶治疗单侧声带麻痹是一种简单、实用、安全的治疗方法.若一次不成功还可以重复治疗.

Intrafold Injection for Unilateral Vocal Cord Paralysis and Evaluation of Vocal Function

Thirty patients with unilateral vocal cord paralysis were treated by transcutaneous intrafold silicone injection. The location of the needle as well as the effect of injection was monitered by means of a fiberscope connected to a television camera and screen. The preoperative and postoperative vocal function were evaluated by means of nineteen measures:maximum phona-tion time(MPT) .mean airflow rate during phonation over comfortable duration(MFR) .fundamental freqency(F0),sound pressure level (SPL) .pitch perturbation quotient (PPQ) .amplitude perturbation quotient(APQ) .normalized noise energy NNEa and NNEb.vocal stroboscopic examination symmetry (SYM ) , regularity (REG ) . glottic closure (GLO ). mucosal wave (MUC ). amplitude (AMP),rough(R),breathy(B),asthenic(A)),strained (S). The results showed that most of the patients whose voice was distinctly improved postoperatively presented a decrease in MFR.PPQ. APQ,NNE and a increase in MPT,GLO, The PPQ,APQ,NNE showed a positive correlated relationship to REG.AMP.MUC. The breathly(B) and asthenic(A) were postively correlated to MFR,REG,GLO,AMP,MUC,SYM.