후두미세수술에서 술 후 음성치료의 역할 및 효과
Role and Effectiveness of Postoperative Voice Therapy in Laryngeal Microsurgery
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Background and Objectives Voice therapy is performed following laryngeal microsurgery to help the recovery of the operation site and assist in optimal voice output. The aim of this study was to evaluate the effect of postoperative voice therapy and to obtain objective evidence about the necessity of voice therapy. Subjects and Method The voice of 109 patients who underwent laryngeal microsurgery for vocal fold lesions and received voice therapy was analyzed. Voice analysis was performed preoperatively, postoperatively, and after the first voice therapy. GRBAS scale was used for auditory perceptual evaluation and acoustic analysis was performed for objective evaluation. Results Overall, significant improvement was observed postoperatively in both auditory perceptual evaluation and acoustic parameters, and significantly better voice was obtained after the first postoperative voice therapy. The degree of postoperative voice improvement varied on the type of vocal fold lesions, but voice quality was improved in all diseases after first postoperative voice therapy. The number of voice therapy decreased significantly as the voice quality improved after the operation or the first voice therapy. Four or more voice therapy were needed when the cepstral/spectral index of dysphonia (CSID) value was 5.88 or higher. Conclusion Voice therapy following laryngeal microsurgery was effective in better voice output. The CSID value after the first postoperative voice therapy was predictive of finding patients who need long-term voice therapy. These results suggest that the first postoperative voice therapy will be helpful in finding the adequate vocalization method and providing objective evidence for selecting patients who would require continuous voice therapy.
Abstract
Background and Objectives Voice therapy is performed following laryngeal microsurgery to help the recovery of the operation site and assist in optimal voice output. The aim of this study was to evaluate the effect of postoperative voice therapy and to obtain objective evidence about the necessity of voice therapy. Subjects and Method The voice of 109 patients who underwent laryngeal microsurgery for vocal fold lesions and received voice therapy was analyzed. Voice analysis was performed preoperatively, postoperatively, and after the first voice therapy. GRBAS scale was used for auditory perceptual evaluation and acoustic analysis was performed for objective evaluation. Results Overall, significant improvement was observed postoperatively in both auditory perceptual evaluation and acoustic parameters, and significantly better voice was obtained after the first postoperative voice therapy. The degree of postoperative voice improvement varied on the type of vocal fold lesions, but voice quality was improved in all diseases after first postoperative voice therapy. The number of voice therapy decreased significantly as the voice quality improved after the operation or the first voice therapy. Four or more voice therapy were needed when the cepstral/spectral index of dysphonia (CSID) value was 5.88 or higher. Conclusion Voice therapy following laryngeal microsurgery was effective in better voice output. The CSID value after the first postoperative voice therapy was predictive of finding patients who need long-term voice therapy. These results suggest that the first postoperative voice therapy will be helpful in finding the adequate vocalization method and providing objective evidence for selecting patients who would require continuous voice therapy.
참고문헌 (16)
- 신유섭, "Persistent Dysphonia after Laryngomicrosurgery for Benign Vocal Fold Disease", Clinical and Experimental Otorhinolaryngology, 6(3), pp.166~170 (2013), 대한이비인후과학회
- Wang NM, "A vocal treatment plan for voice disorders after phonosurgery--a preliminary study", Changgeng Yi Xue Za Zhi, 17(2), pp.144~148 (1994)
- Bequignon E, "Long-term results of surgical treatment of vocal fold nodules", Laryngoscope, 123(8), pp.1926~1930 (2013)[DOI]
- Petrovic-Lazic M, "Acoustic and perceptual characteristics of the voice in patients with vocal polyps after surgery and voice therapy", J Voice, 29(2), pp.241~246 (2015)[DOI]
- Kaneko M, "Optimal duration for voice rest after vocal fold surgery: randomized controlled clinical study", J Voice, 31(1), pp.97~103 (2017)[DOI]
- Wendler J, "Classification of voice qualities", J Phonet, 14, pp.483~488 (1986)
- Fant G, "Acoustic theory of speech production: with calculations based on X-ray studies of Russian articulations" (1970), Mouton
- Lin L, "Effect of voice training in the voice rehabilitation of patients with vocal cord polyps after surgery", Exp Ther Med, 7(4), pp.877~880 (2014)[DOI]
- 서인효, "성대 양성점막 질환에서 수술 전후 음질변화를 객관적으로 반영하는 음향지표 분석", 대한이비인후-두경부외과학회지, 59(11), pp.775~779 (2016), 대한이비인후과학회[DOI]
- 백무진, "양성후두질환에서 합성음성을 이용한 수술 후 음성의 예측", 대한이비인후-두경부외과학회지, 45(3), pp.279~284 (2002), 대한이비인후과학회
- Uloza V, "Perceptual and acoustic assessment of voice pathology and the efficacy of endolaryngeal phonomicrosurgery", J Voice, 19(1), pp.138~145 (2005)[DOI]
- Nemr K, "GRBAS and Cape-V scales: high reliability and consensus when applied at different times", J Voice, 26(6), pp.812.e17~812.e22 (2012)[DOI]
- Park SH, "A study for changes of acoustic parameters between pre and postoperative voice in laryngeal nodule and polyp", Korean J Otolaryngol-Head Neck Surg, 42(5), pp.634~638 (1999)
- Nam SY, "Acoustic analysis of benign vocal cord lesions: before and after microlaryngeal surgery", Korean J Otolaryngol-Head Neck Surg, 41(7), pp.925~928 (1998)
- Zeitels SM, "Management of common voice problems: committee report", Otolaryngol Head Neck Surg, 126(4), pp.333~348 (2002)[DOI]
- Van Lierde KM, "Long-term outcome of hyperfunctional voice disorders based on a multiparameter approach", J Voice, 21(2), pp.179~188 (2007)[DOI]