Utility of preoperative voice therapy on the voice recovery of vocal cord polyps patients undergoing the microsurgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVES@#To evaluate the therapeutic effect on the voice recovery of patients with vocal cord polyps undergoing the microsurgery of preoperative voice therapy.@*METHODS@#Twenty-six patients diagnosed with unilateral vocal cord polyp under stroboscope, who needed to undergo vocal cord loss resection under supportive laryngoscope, were randomly divided into control group (non-voice training) and treatment group (voice training), with each group of 13 patients. Patients in control group were just treated with surgical operation. Apart from surgical treatment, patients in treatment group received 6 hours intensive vocal therapy one week before the surgery. The therapy courses consist of the propaganda and education of voice care, postoperative vocal instruction and the patients' self-training under the guidance of voice therapists. The acoustic parameters (irregularity, breathiness, grade, jitter and shimmer) of the same patient were collected 24 to 48 hours before the surgery and 14 days after the surgery with Ling WAVES. The results were analyzed with SPSS 19.0.@*RESULTS@#The differences of all the five preoperative voice parameters between control group and treatment group are not significant; but postoperative breathiness and jitter in treatment group were significantly lower than that in control group, while the differences of irregularity, overall severity and shimmer were not significant between control group and treatment group. In control group, breathiness and jitter were significantly improved after surgery, while the differences of irregularity, breathiness and shimmer were not significant between preoperation and postoperation. In treatment group, all the five voice parameters were significantly improved after surgery. According to the laryngostroboscopic examination, the vocal fold polyps were excised completely in both groups.@*CONCLUSIONS@#Preoperative voice therapy contributes to the recovery of voice quality of the patients with vocal cord polyps. Combined intervention of surgery and voice therapy is an effective method to treat the patients with vocal cord polyps.

Role of aerodynamic parameters in voice function assessment / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the application and significance of aerodynamic parameters in voice function assessment.</p><p><b>METHODS</b>The phonatory aerodynamic system (PAS) was used to collect aerodynamic parameters from subjects with normal voice, vocal fold polyp, vocal fold cyst, and vocal fold immobility. Multivariate statistical analysis was used to compare measurements across groups.</p><p><b>RESULTS</b>Phonation threshold flow (PTF), mean flow rate (MFR), maximum phonation time (MPT), and glottal resistance (GR) in one hundred normal subjects were significantly affected by sex (P < 0.05), while phonation threshold pressure (PTP), subglottal pressure (SGP), and vocal efficiency (VE) were not (P > 0.05). PTP, PTF, MFR, SGP, and MPT were significantly different between normal voice and voice disorders (P < 0.01), and there were no significant differences among the three disorders (P > 0.05). Receiver operating characteristic (ROC) analysis found that PTP, PTF, SGP, MFR, MPT, and VE in one hundred thirteen voice dis orders had similar diagnostic utility (P < 0.01), with PTP exhibiting the highest area under the curve. The aerodynamic parameters of the three degrees of voice dysfunction due to vocal cord polyps were compared and found to have no significant differences (P > 0.05). PTP, PTF, MFR, SGP and MPT in forty one patients with vocal polyps were significantly different after surgical resection of vocal cord polyps (P < 0.01).</p><p><b>CONCLUSION</b>The aerodynamic parameters can objectively and effectively evaluate the variations of vocal function, and have good auxiliary diagnostic value.</p>

Analysis of reliability and validity of the Chinese version of voice handicap index (VHI) / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the reliability and validity of the Chinese version of voice handicap index (VHI).</p><p><b>METHODS</b>The cross-cultural adaptation of health-related quality of life (HRQOL) measures was used to evaluate the Chinese version of VHI. Five hundred forty six dysphonic patients and 80 control subjects were included, 30 of patients and 20 of control subjects also had Hong Kong version VHI test simultaneously.</p><p><b>RESULTS</b>The internal consistency reliability of overall VHI scores and three subscale scores of the Chinese version of VHI were 0.8657-0.9517. The reliability coefficients (test to retest, 2-week interval) was 0.992 (P < 0.001). The correlation coefficient of overall VHI scores and three subscale scores and internal subscale scores were 0.643-0.904 (P < 0.01). There were no significant difference between the Chinese version and Hong Kong Chinese version (Z = 0.397, P = 0.691 ) with high dependability (r = 0.995, P < 0.001). The factor analysis of construct validity shows that the eigenvalue of 6 factors is above 1. The cumulative proportion was 77.24%. The loading was higher than 0.4 among every item. VHI total scores were significantly higher in dysphonic patients than in control subjects (Z = 17.69, P = 0.000). This is also true for all VHI subscores in the functional (Z = 14.14, P = 0.000), physical (Z = 17.68, P = 0.000) and emotional domains (Z = 15.50, P = 0.000).</p><p><b>CONCLUSIONS</b>The Chinese version of VHI had a good reliability and validity. It can be used to evaluate dysphonic patients.</p>

The significance of assessing the perineural vascular plexus for locating the facial nerve in microsurgery of the ear.

CONCLUSIONS: The perineural vascular plexus is a reliable indicator for the detection of the horizontal segment of the facial nerve in surgery for otologists and neurologists. OBJECTIVE: To evaluate the validity and reliability of the perineural vascular plexus for locating the facial nerve in microsurgery of the ear to avoid iatrogenic facial paralysis. PATIENTS AND METHODS: Our study group comprised 311 patients who underwent tympanoplasty or facial nerve decompression from July 2002 to July 2005. The validity of using the perineural vascular plexus to locate the facial nerve was observed and assessed. RESULTS: The perineural vascular plexus was well differentiated on the horizontal mesotympanic segment of the nerve in 95.8% of patients. The 95% confidence interval was 93.6-98.0%.