Evaluation Of Voice Function And Effect Of Vocal Training On Vocal Process Granuloma After Acid Suppression Therapy

Objective:To explore the effects of acid suppression therapy on vocal cord granuloma,on the day before acid suppression therapy,and the 30^th and 60^th day after it,we gave the objective acoustic test by the dynamic laryngoscope speech analysis software and subjective voice evaluation by the speech impairment index scale?VHI-10?to patients with vocal cord granuloma?n=30?and people without voice disorder?n=30?.Professional voice training was given for 4 weeks to study clinical effects of voice training on these patients.Methods:1.The experimental group consists of 30 patients with vocal process granuloma,while the control group consists of 30 healthy people.Objective voice parameters,including the fundamental frequency perturbation?Jitter?,amplitude perturbation?Shimmer?,maximum phonation time?MPT?and dysphonia severity index?DSI?were detected by the dynamic laryngoscope?Germany,XION Co.,Ltd.?and DIVAS2.1 speech analysis software.The paired t-test was performed on the data of the experimental group obtained on the 30^th and 60^th day after acid suppression therapy,and independent sample t-test was performed between the experimental group and the control group by SPSS22.0software.2.The intervention of voice training group consists of 15 patients which randomly selected from the experimental group,And the rest 15 patients belong to the non-intervention group.3 months after the acid suppression therapy,voice training of 1 month was given to the intervention group.Before and after systematic voice training,objective voice parameters and subjective scale scores of both groups were collected.Independent sample t-tests were performed on data of non-intervention group and intervention group before and after voice training by SPSS22.0 software.Results:1.Before the acid suppression therapy,Jitter and Shimmer of the experimental group were higher than those of the control group,while the MPT and DSI were lower.The difference between experimental group and control group was extremely significant?P<0.01?.2.After 1 month of acid suppression therapy,Jitter and Shimmer of the experimental group were higher than those of the control group,while the MPT and DSI values were lower.The differences between experimental group and control group were very significant?P<0.01?.3.After 3 months of acid suppression therapy,the MPT and DSI of the experimental group were lower than those of the control group and the difference was extremely significant?P<0.01?.There was no significant difference in Jitter and Shimmer between the control group and the experimental group?P>0.05?.4.After one month of acid suppression therapy,the Jitter and Shimmer of experimental group decreased,while the DSI value increased.The difference was statistically significant?P<0.05?,but the difference in MPT was not significant?P>0.05?.After 3 months of acid suppression treatment,the Jitter and Shimmer values were much lower,while the MPT and DSI values increased significantly with a significant difference?P<0.01?.Jitter and shimmer values after 3 months of acid suppression therapy were much lower than those after 1 month of acid suppression,while MPT and DSI values increased with significant difference?P<0.01?.5.The differences of the scores of the VHI-10 scale among one month and three months after acid suppression therapy in both the control group and the experimental group before acid suppression therapy were significant.6.Before voice training:there is no significant difference in VHI-10 scale points,Jitter,Shimmer,MPT and DSI values between the intervention group and the non-intervention group.After voice training:the MPT value of the intervention group was obviously prolonged?t=3.85,P<0.01?and the DSI value of the intervention group was much higher than that of the non-intervention group?t=2.31,P<0.05?.The Jitter and Shimmer values of the intervention group is close to those of non-intervention group?P>0.05?and the VHI-10 scale score of the intervention group was significantly lower than that of the non-intervention group?t=-4.54,P<0.01?.Conclusions:1.The recovery of voice function of patients treated with acid suppression therapy can be quantitatively evaluated by the computerized vocal acoustic analysis and vocal disorder index scale?VHI-10?.After 3 months of acid suppression therapy,the voice quality of patients was significantly improved,but not recovered totally.2.Systematic vocal training and psychological counseling for patients whose vocal function didn't recover after 3 months of acid suppression therapy can correct their bad vocal habits,improve their voice and help them return to society soon.