伴有声带活动障碍的下咽癌患者嗓音学特征分析  

Analysis of vocal characteristics in hypopharyngeal cancer patients with vocal cord dysfunction

作　　者：刘小红[1] 穆国媛 曹楠 李娜[1] 杨敏娟[1] 陈阳娟 杜小滢[1] 任晓勇[1] 罗花南[1] LIU Xiaohong;MU Guoyuan;CAO Nan;LI Na;YANG Minjuan;CHEN Yangjuan;DU Xiaoying;REN Xiaoyong;LUO Huanan(Department of Otolaryngology-Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University,Xian,710004,China)

机构地区：[1]西安交通大学第二附属医院耳鼻咽喉头颈外科,西安710004

出　　处：《临床耳鼻咽喉头颈外科杂志》2024年第11期1056-1060,1065,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：陕西省科技计划资助项目(No:2023-YBSF-356)。

摘　　要：目的:分析伴有声带活动障碍的下咽癌患者其嗓音学特征。方法:回顾性分析2018年1月至2024年4月于西安交通大学第二附属医院初治的下咽癌患者的资料,从中筛选出完成电子喉镜检查、频闪喉镜检查和嗓音分析者,其中存在病变侧声带活动障碍的下咽癌患者设为试验组;而双侧声带活动对称、无声带活动障碍者设为对照组。分析比较试验组和对照组的下咽癌患者其临床基本特征、嗓音学参数及频闪喉镜检查结果。结果:与对照组比较,试验组患者其病变位于梨状窝内侧壁的比例显著增高(83.3%vs 53.8%,P<0.05)。试验组与对照组患者比较,其嗓音学参数如声压级(SPL)、基频微扰(Jitter)、振幅微扰(Shimmer)、最长发音时间(MPT)、嗓音障碍指数(DSI)、基频(F0)、声强、嗓音障碍指数量表(VHI)等比较均差异无统计学意义(P>0.05),但试验组F0、Jitter、Shimmer、VHI值均高于对照组。另外,从频闪喉镜检查结果看,试验组其声门闭合不全(42.9%vs 18.8%)、杓状软骨不对称的患者比例(64.3%vs 0)均显著高于对照组(P<0.05),但试验组和对照组患者均无病变侧的声带黏膜波减弱。试验组接受诱导化疗(尼妥珠单抗+奈达铂+5-氟尿嘧啶)的18例患者,13例声带活动度改善,改善率为72.2%。结论:下咽癌尤其是梨状窝内侧壁癌更易出现声带活动障碍,但声带活动障碍对下咽癌患者的嗓音学参数影响不明显。Objective:To analyze the acoustic characteristics of patients with hypopharyngeal cancer accompanied by vocal cord dysfunction.Methods:A retrospective analysis was conducted on the data of patients with hypopharyngeal cancer who were initially treated at The Second Affiliated Hospital of Xi'an Jiaotong University from January 2018 to April 2024.Patients who had completed electronic laryngoscopy,stroboscopic laryngoscopy,and voice analysis were selected from the data.Among them,patients with hypopharyngeal cancer who had unilateral vocal cord activity disorders were selected as the experimental group,while patients with symmetrical bilateral vocal cord activity were assigned to the control group.Then the clinical characteristics,the vocal parameters,and the stroboscopic laryngoscopy results of patients with hypopharyngeal cancer in the experimental group and the control group were analyzed and compared.Results:Compared with that in the control group,the proportion of lesions located on the inner wall of the piriform fossa in the experimental group increased(83.3% vs 53.8%),and the difference was statistically significant(P<0.05).There was no significant difference in vocal parameters such as SPL,Jitter,Shimmer,MPT,DSI,F0,sound intensity,electroglottic value and VHI between the experimental group and the control group(P>0.05).However,the values of F0,Jitter,Shimmer and VHI in the experimental group were higher than those in the control group.In addition,in terms of the results of stroboscopic laryngoscopy,the proportion of glottic insufficiency(42.9% vs 18.8%) and asymmetric arytenoid cartilage(64.3% vs 0) in the experimental group was significantly higher than that in the control group(P<0.05).However,the mucosal waves of the vocal cords on the affected side did not weaken in patients in both the experimental group and the control group.In the experimental group of 18 patients with hypopharyngeal cancer who received induction chemotherapy(nituzumab+nedaplatin+5-fluorouracil),13 of them had improved vocal cord acti

关 键 词：下咽癌 声带活动障碍 嗓音分析 频闪喉镜 

分 类 号：R762[医药卫生—耳鼻咽喉科]