The Subjective And Objective Study Of Benign Vocal Cord Lesions, Malignant Vocal Cord Lesions

Objective:1By comparing the differences of the voice between thepeople with vocal fold lesions and the normal adualt, to explore theacoustic characterize of the vocal fold lesions.2Explor acoustic measure, theelectroglottograph(EGG)and stroboscopic laryngoscope in evaluation of thepeople with voice dysphonia of the vocal fold lesions, and explore theconsistency and correlation between each other.3To investigate theconsistency and correlation between the subjective assessment and objectiveparameters analysis.4Explore the recovery of voice function in differenttypes of precancerous lesions of vocal cord and golttic carcinoma underdifferent treaments to guide the clinicalwork.Method:1Selecting the object:155patients with voice disorders weregrouped into voice disorders group and200subjects with normal voice weregrouped into control group.2Detection methods: All the patients with voicedisorders and normal people all are tested by Multi Dimensional VoiceProgram(MDVP), all the patients,40healthy men and40healthy womenrandomly chosen from the conrol group received stroboscopic laryngoscope.The recorded voice samples were graded from0for normal to3for severedysphonia according to the G component of the GRBAS. After that, allpatients and30normal men and women filled out a self-assessmentquestionnaire-VHI10. The objective parameters included Fundamentalfrequency(Fo), Highest Fundamental Frequency(Fhi), Lowest FundamentalFrequency(Flo), pitch perturbation(jitter), amplitude perturbation(shimmer),Noise to Harmonic Ratio(NHR), Amplitude Perturbation Quotient(APQ),Contact Quotient(EGG-CQ).Result:1Table1showed F0, Fhi, Flo of normal adult women were higherthan normal adult men, but NHR, EGG-CQ of the normal adult men were higher than normal adult women, the difference is significant(P＜0.05),shimmer, APQ had no significant difference between normal adult women andmen.2Table2showed we can see that except jitter, F0, Fhi, Flo, NHR, EGG-CQ, shimmer in normal adult in each age group are different.3Table3showed we conclude that voice parameters had no significantdifferences between the two types of untreated vocal cord leukoplakia.4Table4showed that the voice parameters including F0, Flo, shimmer,APQ, EGG-CQ had no significant differences between vocal cord leukoplakiaand glottic carcinoma before the operation.But the Fhi, Jitter of golttic carcin-oma were significantly higher than vocal cord leukoplakia before theoperation.5Table5showed that F0, Fhi, Flo, jitter, shimmer, NHR, APQ, EGG-CQhad significant differences between normal subjects, golttic carcinoma andvocal cord leukoplakia(P＜0.05). Fo, flo, EGG-CQ of vocal cord leukoplakiawere significantly lower than normal group(P<0.05), but jitter, shimmer, NHR,APQ were significantly higher than normal group(P<0.05). Fhi had nosignificant differences between vocal cord leukoplakia and the normal group.Fhi, jitter, shimmer, NHR, EGG-CQ of the vocal nodule were significantlyhigher than normal group(P <0.05).6Table6showed the value of APQ had significant difference before andafter3months of glottic carcinoma operation.7Table7showed the value of the parameters had no significant differencebefor opertaion and after1month of laser operation.8Table9showed the value of Fo, Fhi, Shimmer, NHR, APQ, EGG-CQincresed with the severity of the horness.9Table10showed the score of the F, E, P and TVH have significantdifferences between the normal group and the group with vocal fold lesions.10Table11showed G had well correlation with each voice parameters,TVH correlated moderately with each voice parameters. APQ and shimmerhad well correlation with each other. Conclusion:1Attempt to create a normal human voice objective andsubjective multidimensional parameter model. Men’s NHR, EGG-CQ ishigher than women’s, but women’s Fo, Fhi and Flo is higher than men’s, inaddition, Women’s Fo decrease with the increasing age.2Computer objectiveacoustic multidimensional parameter detection has a good clinical diagnosticvalue to distinguish the benign and malignant lesions of vocal cord. Jitter,Shimmer, APQ, NHR, EGG-CQ are sensitive parameters, which can provide areference for the diagnosis and assessment of the benign and malignantlesions of vocal cord.3The objective acoustic parameter detection can used toevaluate the response of therapy. The Fo, Jitter, Shimmer, APQ have somereference value.4Subjective and objective assessment of voice disorders havesome correlation. The value of objective parameters can reflect the subjectiveevaluation to some extent. The subjective assessments are effected by theeducation level and intellect of the patients.