성대 백반증의 혈관용해 레이저 수술 후 2D 스캐닝 디지털 카이모그래피를 이용한 성대 진동 변화의 양적 평가
A Quantitative Examination of Vocal Fold Vibratory Changes Using Two-Dimensional Scanning Digital Kymography After Angiolytic Laser Stripping for Vocal Fold Leukoplakia
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Background and Objectives Vocal fold leukoplakia is characterized as white plaque onthe epithelium of the vocal folds and can be treated by angiolytic laser stripping surgery. How-ever, postoperative changes in the vibratory patterns of vocal folds have not been investigatedquantitatively. The purpose of this study was to investigate the changes in vocal fold vibrationafter angiolytic laser surgery in patients with unilateral vocal fold leukoplakia using the two-dimensional scanning digital kymography (2D DKG). Subjects and Method Medical records of seven males (age=62 .14±12.40 yrs) with unilat-eral vocal fold leukoplakia who underwent angiolytic laser stripping were reviewed. Beforeand after the surgery (post-operative day=82.57±28.55 days), a multi-dimensional voice as-sessment was performed along with a 2D DKG study. For 2D DKG images, the amplitudesymmetry index (ASI), phase symmetry index (PSI), and open quotient (OQ) were calculatedusing the ImageJ program. In addition, pre- versus postoperative data were compared, and thecorrelation between the changes in 2D DKG parameters and voice outcomes was explored. Results Results indicated that the absolute ASI ( p=0.028) and OQ ( p=0.028) of the 2DDKG study, grade ( p=0.038) and breathy ( p=0.034) of the GRBAS scale, σPitch measured bythe electroglottography ( p=0.043), the physical score of the VHI ( p=0.042), and the total score( p=0.043) and the tiredness score ( p=0.043) of the VFI decreased after surgery. Decrease inthe absolute ASI was correlated with changes in the grade (rho=0.850) and breathy (rho=0.777)scale measures, while decreased OQ were correlated with the changes in the physical score ofthe VHI (rho=0.901) and tiredness score of the VFI (rho=0.847). Conclusion The improved vocal fold vibratory patterns after angiolytic laser surgery forvocal fold leukoplakia can be evaluated objectively using the 2D DKG study. Angiolytic laserstripping enables the preservation of vocal fold vibration after the surgery and is considered avaluable surgical option for treating vocal fold leukoplakia.
Abstract
Background and Objectives Vocal fold leukoplakia is characterized as white plaque onthe epithelium of the vocal folds and can be treated by angiolytic laser stripping surgery. How-ever, postoperative changes in the vibratory patterns of vocal folds have not been investigatedquantitatively. The purpose of this study was to investigate the changes in vocal fold vibrationafter angiolytic laser surgery in patients with unilateral vocal fold leukoplakia using the two-dimensional scanning digital kymography (2D DKG). Subjects and Method Medical records of seven males (age=62 .14±12.40 yrs) with unilat-eral vocal fold leukoplakia who underwent angiolytic laser stripping were reviewed. Beforeand after the surgery (post-operative day=82.57±28.55 days), a multi-dimensional voice as-sessment was performed along with a 2D DKG study. For 2D DKG images, the amplitudesymmetry index (ASI), phase symmetry index (PSI), and open quotient (OQ) were calculatedusing the ImageJ program. In addition, pre- versus postoperative data were compared, and thecorrelation between the changes in 2D DKG parameters and voice outcomes was explored. Results Results indicated that the absolute ASI ( p=0.028) and OQ ( p=0.028) of the 2DDKG study, grade ( p=0.038) and breathy ( p=0.034) of the GRBAS scale, σPitch measured bythe electroglottography ( p=0.043), the physical score of the VHI ( p=0.042), and the total score( p=0.043) and the tiredness score ( p=0.043) of the VFI decreased after surgery. Decrease inthe absolute ASI was correlated with changes in the grade (rho=0.850) and breathy (rho=0.777)scale measures, while decreased OQ were correlated with the changes in the physical score ofthe VHI (rho=0.901) and tiredness score of the VFI (rho=0.847). Conclusion The improved vocal fold vibratory patterns after angiolytic laser surgery forvocal fold leukoplakia can be evaluated objectively using the 2D DKG study. Angiolytic laserstripping enables the preservation of vocal fold vibration after the surgery and is considered avaluable surgical option for treating vocal fold leukoplakia.
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