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J Korean Soc Laryngol Phoniatr Logop > Volume 21(2); 2010 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2010;21(2): 121-127.
일측성 성대마비 환자에서 음성치료 효과를 예측할 수 있는 인자
정고은, 김성태, 김상윤, 노종렬, 남순열, 최승호
울산대학교 의과대학 서울아산병원 이비인후과학교실
Factors Predictive of Voice Therapy Outcome in Patients with Unilateral Vocal Fold Paralysis
Go-Eun Jeong, Seong-Tae Kim, Sang-Yoon Kim, Jong-Lyel Roh, Soon-Yuhl Nam, Seung-Ho Choi
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine
ABSTRACT
Background and Objectives : Unilateral vocal fold paralysis is generally treated using injection laryngoplasty or voice therapy. However, the decision of treatment method is dependent on clinician's preference and hospital facilities without specific criteria. The purpose of the study was to examine factors predictive of voice therapy outcome in patients with unilateral vocal fold paralysis. Materials and Method : 38 patients diagnosed as unilateral vocal fold paralysis, aged from 24 to 81 years and undergone voice therapy more than 1 month were included. After 3 to 12 (mean 5.1) sessions of voice therapy, subjects had divided into responder group (RG, 28 patients) and non-responder group (NRG, 10 patients) according to G scale change. Paramters of perceptual assessment, acoustic and aerodynamic measure, and videostroboscopy were compared between two groups, and factors predictive of voice therapy result were analyzed. Results : RG patients showed significantly reduced rough, breathy, asthenic voice after voice therapy. Change of MPT and MFR was more substantial in RG than in NRG. By videostroboscopy, RG patients showed significantly more mucosal wave symmetry, glottal closure, reduced glottal gap index during the closed phase of phonation, while NRG patients showed more occurrences of abnomal supraglottic activities during phonation (p < 0.05). Poor outcome of voice therapy significantly associated with increased asthenic scale, short MPT, and less glottal closure (p=0.02). In addition, 90% of patients with MPT more than 5 seconds were in RG, whereas 56% of patients with MPT less than 5 secondes were in RG. Conclusion : Voice therapy is useful for large proportion of patients with unilateral vocal fold paralysis as an initial treatment method. However, patients with large asthenia scale, large glottic gap or MPT less than 5 seconds tend to have poor voice therapy outcome, and early injection laryngoplasty maybe recommended for these patients.
KEY WORDS: Unilateral vocal fold paralysis;Voice therapy;Predictive factors;
중심 단어: 일측성 성대마비;음성치료;예측인자;
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