성대 백반증의 혈관용해 레이저 수술 후 2D 스캐닝 디지털 카이모그래피를 이용한 성대 진동 변화의 양적 평가

최지훈; 임재열; 이승진; 채혜림; 강민석; 박영민; 왕수건

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자료유형: 학술저널

저자정보: 최지훈 (연세대학교 의과대학 강남세브란스병원 이비인후과학교실) 임재열 (연세대학교 의과대학 강남세브란스병원 이비인후과학교실) 이승진 (한림대학교 자연과학대학 언어청각학부 및 청각언어연구소) 채혜림 (연세대학교 의과대학 강남세브란스병원 이비인후과학교실) 강민석 (연세대학교 의과대학 강남세브란스병원 이비인후과학교실) 박영민 (연세대학교 의과대학 강남세브란스병원 이비인후과학교실) 왕수건 (부산대학교 의과대학 이비인후과학교실)

저널정보: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후-두경부외과학회지 제66권 제6호

발행연도: 2023.6

수록면: 393 - 399 (7page)

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Background and Objectives Vocal fold leukoplakia is characterized as white plaque onthe epithelium of the vocal folds and can be treated by angiolytic laser stripping surgery. How-ever, postoperative changes in the vibratory patterns of vocal folds have not been investigatedquantitatively. The purpose of this study was to investigate the changes in vocal fold vibrationafter angiolytic laser surgery in patients with unilateral vocal fold leukoplakia using the two-dimensional scanning digital kymography (2D DKG). Subjects and Method Medical records of seven males (age=62 .14±12.40 yrs) with unilat-eral vocal fold leukoplakia who underwent angiolytic laser stripping were reviewed. Beforeand after the surgery (post-operative day=82.57±28.55 days), a multi-dimensional voice as-sessment was performed along with a 2D DKG study. For 2D DKG images, the amplitudesymmetry index (ASI), phase symmetry index (PSI), and open quotient (OQ) were calculatedusing the ImageJ program. In addition, pre- versus postoperative data were compared, and thecorrelation between the changes in 2D DKG parameters and voice outcomes was explored. Results Results indicated that the absolute ASI ( p=0.028) and OQ ( p=0.028) of the 2DDKG study, grade ( p=0.038) and breathy ( p=0.034) of the GRBAS scale, σPitch measured bythe electroglottography ( p=0.043), the physical score of the VHI ( p=0.042), and the total score( p=0.043) and the tiredness score ( p=0.043) of the VFI decreased after surgery. Decrease inthe absolute ASI was correlated with changes in the grade (rho=0.850) and breathy (rho=0.777)scale measures, while decreased OQ were correlated with the changes in the physical score ofthe VHI (rho=0.901) and tiredness score of the VFI (rho=0.847). Conclusion The improved vocal fold vibratory patterns after angiolytic laser surgery forvocal fold leukoplakia can be evaluated objectively using the 2D DKG study. Angiolytic laserstripping enables the preservation of vocal fold vibration after the surgery and is considered avaluable surgical option for treating vocal fold leukoplakia.

#Kymography #Lasers #Leukoplakia #Vibration #Vocal cords.

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