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J Korean Soc Laryngol Phoniatr Logop > Volume 15(2); 2004 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2004;15(2): 128-132.
조기 후두암 환자에서 보전적 후두수술 후 음성 변화
이윤세1, 박정제2, 최승호1, 김상윤1, 남순열1
1울산대학교 의과대학 서울아산병원 이비인후과교실
2경상대학교 의과대학 이비인후과학교실
The Voice Change after Conservative Laryngeal Surgery
Yoon-Se Lee1, Jung-Je Park2, Seung-Ho Choi1, Sang-Yoon Kim1, Soon-Yuhl Nam1
1Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine
2Department of Otolaryngology, College of Medicine, Gyeongsang National University
ABSTRACT
Objectives : The total laryngectomy for laryngeal cancer has made patients be afraid of voice loss. Early staged glottic or supraglottic cancer can be treated with conservative laryngeal surgery which preserve voice, though which was not normal voice comparing before. Voice analysis is used to evaluates objectively the quality of the voice in pre- and postoperation, 4 different types of conservative laryngeal surgery : laser cordectomy, supracticoid partial laryngectomy, vertical partial laryngectomy, and supralottic laryngectomy.
Materials and Method
s : The patients who received conservative laryngeal surgery(laser cordectomy : 23 cases, vertical partial laryngecotmy : 9cases, supracriocoid partial laryngectomy : 6cases, supraglottic laryngectomy : 8cases) from 1995 to 2001 in the Asan medical center. Fundamental frequency(F0), shimmer, jitter, noise to harmony ratio(NHR), maximum comfortable phonation time and subglottic pressure were used as parameters for voice analysis.
Results
: The patients who received laser cordectomy(shimmer : 5.26${pm}$1.12%, jitter : 3.33${pm}$0.42%, NHR : 0.47${pm}$0.02, MPT : 9.32${pm}$3.59sec) and supraglottic laryngectomy(shimmer : 4.39${pm}$1.03%, jitter : 1.49${pm}$0.14%, NHR : 0.51${pm}$0.06, MPT : 8.9${pm}$0.59sec) showed better results than other two procedures, but differed from normal value. Especially the patients who received supracricoid partial laryngectomy(shimmer : 9.23${pm}$1.56%, jitter : 5.81${pm}$1.23%, NHR : 5.89${pm}$1.13, MPT : 6.3${pm}$1.18sec, MFR : 632${pm}$89ml/sec) had poorer quality of voice but presented fast functional recovery time, and the subjective symptom was improved as time goes by slowly.
Conclusion
: The appropriate conservative laryngeal surgery for each cancers and stage can preserve the acceptable voice for patients. Supracricoid partial laryngectomy for T1b glottic cancer can be used for acceptable voice despite its poor voice analysis.
KEY WORDS: Laryngeal neoplasm;Laryngectomy;Voice qualtiy;
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