Clinical Study On The Efficacy Of CO₂ Laser Resection Combined With Ganju Bingmei Tablets In The Treatment Of Vocal Cord Polyps Under Bracing Laryngoscope

Research background and purpose:Vocal fold polyp is a common disease in otorhinolaryngology,mainly manifested as hoarseness,articulation fatigue and other discomforts,the incidence of which has been increasing in recent years.Therefore,post-surgical adjuvant therapy should be an important measure to promote vocal fold recovery and prevent disease recurrence.In the literature,there are reports on the clinical efficacy of cold instrumentation surgery combined with Ganju Bingmei tablet in the treatment of vocal cord polyp,but there are no reports on the efficacy of CO₂ laser surgery combined with Ganju Bingmei tablet in the assessment of vocal cord polyp by stroboscopic laryngoscopy and voice acoustic analysis.Therefore,in this study,we compared the clinical outcomes（improvement of patients’conscious symptom,vocal sound and vocal fold by stroboscopic laryngoscopy,VHI scale and voice acoustic analysis）,voice function（voice acoustic parameters）and self-perception（VHI total score）of CO₂ laser resection combined with Ganju Bingmei tablet under general anesthesia and CO₂ laser surgery alone for vocal fold polyp.To investigate the clinical significance and application value of CO₂ laser surgery combined with Ganju Bingmei tablet in the treatment of vocal cord polyp.Materials and Methods:Forty patients with vocal cord polyp treated in the Department of Otorhinolaryngology head and neck surgery of Yibin first people’s Hospital from March2022 to September 2022 were randomly divided into two groups with 20 patients in each group（n=20）.The control group was treated with CO₂ laser resection of vocal cord polyps under general anesthesia supporting laryngoscope,and the study group was treated with Ganju Bingmei tablet on the basis of the control group.The patients were tested with VHI scale 1-3 days before operation,1 month after operation and 3 months after operation.The voice acoustic parameters such as fundamental frequency perturbation（Jitter）,amplitude perturbation（Shimmer）,fundamental frequency（F0）,sound pressure level（SPL）,maximum phonatory time（MPT）and dysphonia severity index（DSI）were obtained by using stroboscopic laryngoscope and DIVAS2.8 voice analysis software made by XION company in Germany.The above data were analyzed by SPSS26.0 statistical software.The total score of VHI scale and voice parameters between groups and in the same group were analyzed by repeated measurement analysis of variance.Fisher exact probability method was used to compare the total effective rate between the two groups.Result:1.The total effective rate of treatment in the study group（95.00%）was higher than that in the control group（85.00%）at 1 month after surgery,and the difference was statistically significant（P<0.05）.There was no statistically significant difference in the total effective rate of treatment between the two groups at 3 months after surgery（P>0.05）.2.Study group:Jitter,Shimmer,MPT,DSI,VHI and SPL at 1 month postoperatively and 3 months postoperatively were statistically significant（P<0.05）compared with preoperative;SPL at 1 month postoperatively,F0 at 1 month postoperatively and 3 months postoperatively were not statistically significant（P>0.05）compared with preoperative.In the control group:Shimmer,VHI at 1 month postoperatively,VHI at 3 months postoperatively and Jitter,MPT and DSI at 3 months postoperatively compared with preoperatively,the differences were statistically significant（P<0.05）;Jitter,F0,MPT,DSI,SPL at 1 month postoperatively and SPL and F0 at 3 months postoperatively compared with preoperatively,the differences were not statistically significant（P>0.05）.3.3 months postoperatively compared with 1 month postoperatively:（1）Study group:Jitter,MPT,DSI,VHI,statistically significant difference（P<0.05）;Shimmer,SPL,F0,no statistically significant difference（P>0.05）.（2）Control group:Jitter,Shimmer,MPT,DSI,VHI,the difference was statistically significant（P<0.05）;SPL,F0,the difference was not statistically significant（P>0.05）.4.1 month after surgery:Shimmer and DSI were compared between the two groups,and the difference was statistically significant（P<0.05）;Jitter,SPL,F0,MPT and VHI were compared between the two groups,and the difference was not statistically significant（P>0.05）.5.3 months after surgery,there was no statistically significant difference between the two groups when comparing Jitter,Shimmer,DSI,SPL,F0,MPT,and VHI（P>0.05）.Conclusion:CO₂ laser surgery combined with Ganju Bingmei tablet can effectively improve the clinical outcome and voice function of patients with vocal fold polyp in the early postoperative period and promote the recovery of the vocal fold in the early postoperative period.