Vokal kord nodül, polip ve intraepitelyal neoplazilerinin yönetiminde kullanılabilecek pratik bir algoritma sunumu
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada vokal kord nodül, polip ve intraepitelyal neoplazilerinin videolarengostroboskopi (VLS) ve çok boyutlu ses analiz programına (MDVP) dayanarak doğru şekilde tanıları kondu ve tedavi yöntemleri seçildi. Hastalar ve Yöntemler: Çalışmada son beş yıl içinde kliniğimiz foniyatri biriminde tedavi ve takibi uygulanan ve 218’ine nodül, 101’ine polip ve 78’ine vokal kord intraepitelyal neoplazileri tanısı konulan toplam 397 hastanın (214 erkek, 183 kadın; ort. yaş 46.2 yıl; dağılım 17-71 yıl) VLS bulguları, MDVP ile elde edilen yüzde jitter, yüzde shimmer, fundamental frekans, gürültü-harmonik oranı değerleri, GRBAS ölçeği [Sesteki anormalliğin genel göstergesi (G), Pürüzlülük (R), Konuşmada hava kaçağı (B), Sesteki güçsüzlük (A), Zorlanma, gerginlik (S)] skorları ve ses handikap endeksleri (SHE) retrospektif olarak incelendi. Bulgular: Vokal kord nodülerinde ses eğitimi, poliplerinde ise cerrahi tedavi sonrasında hastaların ses parametrelerinde, GRBAS ve SHE skorlarında iyileşme yönünde bulgular saptanırken intraepitelyal neoplazi grubunda ise tanısal fonocerrahi sonrasında bu skorların kötüleştiği saptandı. Sonuç: İlk muayenede vokal kord nodülü saptananlarda ilk tedavi yöntemi olarak ses eğitimi verilmeli ve tedaviye vereceği yanıtına bakılmalıdır. Larenks kanseri düşünülürse, biyopsi sonucuna göre cerrahi planlanmalı, polip saptanırsa öncelikle biyopsi yapılmalıdır.
Objectives: This study aims to offer an accurate diagnosis for vocal cord nodules, polyps, and intraepithelial neoplasias through videolaryngostroboscopy (VLS) and multi-dimensional voice analysis program (MDVP) and to decide management modalities. Patients and Methods: A total of 397 patients (214 males, 183 females; mean age 46.2 years; range 17 to 71 years) with 218 nodules, 101 polyps and 78 vocal cord intraepitelial neoplasias who were admitted for treatment and follow-up in phoniatry unit of our clinic in the past five years were retrospectively analyzed in terms of VLS findings, the percent of jitter, percent of shimmer, fundamentally frequency, noise-harmonic ratio values, GRBAS [Grade of dysphonia (G), roughness (R), breathiness (B), asthenicity (A) and strain (S)] scores, and voice handicap index (VHI) obtained by MDVP. Results: We obtained better voice parameters with improved GRBAS and SHE scores in patients with vocal cord nodules who underwent voice training and those with polypys who were operated, while these scores worsened following diagnostic phonosurgery in the intraepithelial group. Conclusion: In the initial examination, patients who are prediagnosed vocal cord nodules should have voice therapy as the first-line treatment modality and checked for the response to treatment. If laryngeal cancer is suspected, surgery should be planned according to the biopsy result and biopsy should be performed, if polyp is present.
Objectives: This study aims to offer an accurate diagnosis for vocal cord nodules, polyps, and intraepithelial neoplasias through videolaryngostroboscopy (VLS) and multi-dimensional voice analysis program (MDVP) and to decide management modalities. Patients and Methods: A total of 397 patients (214 males, 183 females; mean age 46.2 years; range 17 to 71 years) with 218 nodules, 101 polyps and 78 vocal cord intraepitelial neoplasias who were admitted for treatment and follow-up in phoniatry unit of our clinic in the past five years were retrospectively analyzed in terms of VLS findings, the percent of jitter, percent of shimmer, fundamentally frequency, noise-harmonic ratio values, GRBAS [Grade of dysphonia (G), roughness (R), breathiness (B), asthenicity (A) and strain (S)] scores, and voice handicap index (VHI) obtained by MDVP. Results: We obtained better voice parameters with improved GRBAS and SHE scores in patients with vocal cord nodules who underwent voice training and those with polypys who were operated, while these scores worsened following diagnostic phonosurgery in the intraepithelial group. Conclusion: In the initial examination, patients who are prediagnosed vocal cord nodules should have voice therapy as the first-line treatment modality and checked for the response to treatment. If laryngeal cancer is suspected, surgery should be planned according to the biopsy result and biopsy should be performed, if polyp is present.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Kulak Burun Boğaz İhtisas Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
2
