The Analysis And Comparison Of Benign Vocal Cord Lesions Treated By Different Operation Types

Objective:vocal nodules and vocal polyps are the most common benign vocal cord lesions, surgical removal of lesions is an effective treatment. Currently, surgery mode selection criteria for benign vocal fold vary. In this study, we compared the differences of acoustic parameters of vocal nodules and vocal polyps to evaluate the acoustic parameters using different procedures for the treatment, so as to make the acoustic parameters as the standard of the clinical evaluation, as well as the variation of acoustic parameters, so it can give evidence for using acoustic parameters to choose the treatment and clinical evaluation.Methods:We chose 106 cases of vocal cord benign lesion at the Second Hospital of Tianjin Medical University and Tianjin Tianhe Hospital during Nov.2008-Nov. 2009, the clinical diagnosis by dynamic laryngoscope or electronic fiberoptic laryngoscope, and through confirmed by pathological diagnosis. Among them,38 patients with vocal nodules and 68 patients with vocal polyp, in vocal polyp group, by the examination of dynamic laryngoscope or electronic fiberoptic laryngoscope, we find 20 cases with a narrow pedicle,48 cases with sessile polyps, and vocal cord polyps in the group is less than 6mm. The patients of vocal nodules group are at least after 10 days treatment of inhalation and proved invalid.10 patients with pedunculated polyp were operated by fiberoptic laryngoscope under local anesthesia, 10 cases were operated under general anesthesia by microscopic laryngeal surgery.20 patients with sessile polyp were operated under general anesthesia,28 cases were operated by micro laryngeal surgery.18 patients with vocal nodules were operated by fiberoptic laryngoscope under local anesthesia,20 cases were operated by micro laryngeal surgery under general anesthesia. Select 30 healthy people with normal pronunciation, no throat diseases and surgery, no respiratory, digestive and nervous system diseases, no smoking and alcohol in the same period as control group. Using "multi-channel voice and resonance analysis system" developed by Huang Yongwang and other test control group and treatment group before and after 1 week,2 weeks after surgery, after 3 weeks.and 4 weeks after the voice parameters were statistically analyzed. Comparing acoustic parameters between different periods to evaluate the efficacy of two surgical methods in the same group to study the change of acoustic parameters and found that recovery of vocal cord benign lesion after surgery to guide prognosis and evaluate treatment results.Results:The acoustic parameter of vocal cord benign postoperative recovery stage is presented, different parameter of recovery time is different, and generally in1 to 4 weeks, for different operation, postoperative recovery is not exactly the same.1. For the pedicled polyp patients, the acoustic parameters after microsurgery and laryngoscope, there is no significant difference.2. The acoustic parameters of sessile polyp patients after microsurgery returned to normal in two weeks, while the laryngoscope group shimmer values returned to normal in about 3 weeks, jitter and NNE value need 4 weeks to be completely back to normal, compared two groups, The difference is obvious, microsurgery group was significantly better than the laryngoscope group.3. Patients with vocal nodules, the shimmer values of microsurgery group returned to normal in 1 week, jitter and NNE values returned to normal in 2 weeks, shimmer values of laryngoscope group that returned to normal in 2 weeks, jitter and NNE in 3 weeks returned to normal.Conclusion:1. Voice acoustic analysis of vocal cord benign lesion can be an objective reference as surgical selection, evaluation of surgical treatment, postoperative recovery of acoustic parameters.2. By analyzing voice parameters after taking different treatments for different benign laryngeal lesions, we believe that the micro laryngeal surgery is the best choice for sessile polyp and vocal nodules, for pedicle vocal cord polyps, fiberoptic laryngoscope surgery and microscopic laryngeal surgery, there is the same effect.3. The postoperative recovery of acoustic parameters of vocal cord benign, different diseases, different surgical methods,had different results. By micro laryngeal surgery, it needed 2 weeks to return normal; By electronic nasopharyngoscop for pedunculated vocal cord polyps,2 weeks returned to normal, vocal nodules in 3 weeks, sessile polyp in 4 weeks back to normal. Corresponding to the time of sound off is different after surgery.