杓状软骨内移术对改善声带麻痹患者发音功能的作用

目的 :评价杓状软骨内移术对声带麻痹患者发音功能的疗效。方法 :用喉空气动力学检查及嗓音分析方法 ,对 5 6例杓状软骨内移术患者手术前后最大发声时 (MPT)、平均呼气流率 (MFR)、声强 (SPL )、发音时呼气压 (EP) ,以及用 GRBAS法进行的嗓音听觉评价的嘶哑度 (G)进行了比较。结果 :术后 :MPT平均值男延长了3.1倍 ,女延长了 2 .7倍 ;MFR平均值显著下降 ,男从 82 7.3ml/ s下降到 34 0 .3ml/ s,女从 477.1m l/ s下降到 15 8ml/ s(P <0 .0 1) ;SPL平均值升高 ;EP平均值下降 ;G的平均值从 2 .8下降到 1.7(P <0 .0 1) ,改善程度在 1级以上的占 71%。结论 :杓状软骨内移术可使喉的发音功能得到显著改善 ,是非常安全、有效的手术方法之一。

Effect of arytenoid adduction operation for vocal function of laryngeal palsy patients

OBJECTIVE: To evaluate the curative efficiency on vocal function of 56 laryngeal palsy patients underwent arytenoid adduction operation. METHOD: Voice analysis and laryngeal aerodynamical measurement were performed for the 56 laryngeal palsy patients to compare maximum phonation time (MPT), mean flow rate (MFR), voice intensity(SPL), and expiratory pressure(EP) before and after operation. Perceptual evaluation was also performed for comparison by using GRBAS system(G). RESULT: The postoperative average MPT increased by 3.1 times in males and 2.7 times in females. The average MFR decreased apparently from 827.3 ml/s in males and 477.1 ml/s in females before operation to 340.3 ml/s and 158 ml/s after operation, which was statistically significant (P < 0.01). The average SPL increased and the average EP decreased after operation. After operation the average G decreased from 2.8 to 1.7 (P < 0.01) and the percentage of improvement over one grade was 71%. CONCLUSION: From these results mentioned above, it can be concluded that the arytenoid adduction operation might be one of the most effective operative methods to improve glottal incompetence caused by laryngeal nerve paralysis.