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Objective@#To analyze the clinical features of perianal condyloma acuminatum in HIV infected men who have sex with men (MSM) and assess the effects of combined treatment of microwave and photodynamic therapy.@*Methods@#Clinical and laboratory data of 260 male patients with perianal condyloma acuminatum were collected and microwave combined with photodynamic therapy was applied on them.@*Results@#The majority of the patients with perianal condyloma acuminatum were young people (243/260). Warts were mainly located in the anus or from the outside to inside of the anus (245/260). Among them, the proportion of warts position of extraanal in HIV-infected group (8/220) was lower than that of non-HIV-infected group (7/40). HPV types 11 (70/118), 6 (44/118) and 16 (40/118) were the most common types of HPV infection. People with HIV infection were more likely to develop high-risk, mixed types HPV infection and multiple HPV infection than those without HIV infection. More than half of the patients (146/260) needed only 1-3 sessions of photodynamic treatments. There was no significant difference in the times of photodynamic treatments and the numbers of photosensitizers required between the HIV-infected and non-HIV-infected groups. The recurrence rate of HIV-infected group (13.6%, 30/220) was also similar to that of non-HIV-infected group (15.0%, 6/40), but far lower than those who underwent microwave therapy alone (45%, 18/40).@*Conclusions@#The combination therapy significantly reduced the recurrence rate of perianal condyloma acuminatum in HIV infected MSM.
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Objective@#To investigate the value of acoustic parameters in the voice therapy for patients with unilateral vocal cord paralysis (UVCP).@*Methods@#From May 2015 to April 2018, 51 patients with UVCP and 59 healthy controls in Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, were involved in this research retrospectively. The UVCP patients were diagnosed with stroboscopic laryngoscopy. The minimum glottal area (MGA) was calculated by KIPS software when the people were pronouncing/i:/. The fundamental frequency (F0), Jitter, Shimmer and NHR were detected by CSL4500 multiple acoustic voice analyzer.@*Results@#MGA of UVCP patients was much higher than that of healthy control (male: 433.68±64.52 vs. 294.41±51.82, t=9.23, P=0.000; female: 498.80±73.42 vs. 302.03±76.54, t=13.21, P=0.000), which meaned vocal cord insufficiency.After voice therapy, MGA reduced significantly (male: 288.48±55.09, female: 258.22±57.17, t=24.41 and 31.22, P=0.000 vs. pre-therapy). MGA of untreated patients decreased in varying degrees. Compared with the voice therapy group, the MGA decreased in a significantly lower extent (24.25±22.91 vs. 188.31±54.37, t=8.97, P=0.000). The F0, Jitter, Shimmer and NHR raised significantly in UVCP patients group (P=0.000 vs. healthy control group), and they were reduced by voice therapy (all P<0.05). Each of the four acoustic parameters was relative with MGA, r=0.551, 0.867, 0.853 and 0.875 in turn, P=0.001, 0.000, 0.000, and 0.000.@*Conclusion@#MGA and acoustic parameters can reflect the acoustic features of UVCP patients, which are useful tools in the UVCP assessment and voice therapy.
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OBJECTIVE To investigate the effect of obstructive sleep apnea hypopnea syndrome(OSAHS) on the quality of voice. METHODS Electroglottography (EGG) method was used for detecting the vocal cords vibration, waveforms of electroglottography and voice parameters such as Jitter, Shimmer, normalized noise energy (NNE), contact quotient(CQ), contact index (CI), contact quotient perturbation(CQP), contact index perturbation(CIP), and the in 82 OSAHS patients and 53 healthy subjects. The voice parameters were analyzed with Dr.Speech software, RESULTS While in normal pronunciation, the Jitter, Shimmer, NNE, CQP and CIP were (1.037±1.493)%, (5.627±1.872)%, (-16.109±1.719)dB, (2.638±0.633)% and (166.789±30.492)% in 22 mild OSAHS patients, (1.578±0.362)%, (8.478±1.635)%, (-11.517±1.614)dB, (6.043±0.936)% and (255.210±91.224)% in 24 moderate OSAHS patients, and (2.138±1.384)%, (14.888±4.089)%, (-7.677±2.151)dB, (11.749±7.164)% and (431.233±259.266)%in 36 severe OSAHS patients respectively. They were all higher than those in 53 normal subjects as (0.517±0.303)%, (3.299±2.196)%, (-21.933±5.477)dB, (1.322±0.942)% and (58.834±131.849)%. The regularity of vocal fold vibration in all patients with OSAHS was seriously out of whack. EGG waveform was irregular. CONCLUSION The OSAHS patients have structural changes in their upper airway, it will cause non-physiological breathing and lead dry of the vocal cord mucosa and weak elasticity. Their EGG parameters will get higher and vibration will be irregular seriously. We should pay attention to the voice qualities of the OSAHS patients and let them receive treatment as early as possible.
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[ABSTRACT]OBJECTIVETo study the clinical effect of CO2 laser in the treatment of hypertrophic ventricular dysphonia.METHODSFrom December 2011 to December 2013, 40 patients with hypertrophic ventricular dysphonia were treated in our department. Conservative treatment had no valid for all of them. All the patients were examined with strobolaryngoscope and voice analysis (including fundamental frequency, jitter, shimmer and harmonic to noise). After general anesthesia, the hypertrophic ventricular cords were excised with CO2 laser under suspension laryngoscope.RESULTS The Hoarseness were better in all the patients after operation. The ventricular cord and mucosal waves of the vocal cord were normal. The jitter and shimmer were lower than that before operation, but the fundamental frequency and harmonic to noise were higher than that before operation. There were no complications. CONCLUSIONThe treatment of hypertrophic ventricular dysphonia with CO2 laser under suspension laryngoscope is safe, reliable and practical.
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Objective To explore the clinic value of the vocal acoustics on voice evaluation in larynx leukoplakia pa?tients. Methods Dr. Speech software was used to perform voice acoustic analysis and deduce EGG parameters in 48 sub?jects with larynx leukoplakia and 50 normal subjects. Voice acoustic analysis parameters (Jitter, Shimmer, NNE, HNR, SNR, MPT), EGG parameters ( EGG-Jitter、EGG-Shimmer、EGG-NNE、EGG-HNR、EGG-SNR, CQP,CIP) and EGG wave?form were compared between two groups. Results For voice acoustic analysis, Jitter, Shimmer, NNE in larynx leukoplakia group were higher than those in normal group while HNR, SNR in larynx leukoplakia group were lower than those of normal group. What’s more,MPT in larynx leukoplakia group was obviously shorter than that in normal group with, statistically sig?nificant difference (P<0.05). For EGG analysis, EGG-Jitter, EGG-Shimmer, EGG-NNE were higher in larynx leukoplakia group than those in normal group with significant difference (P<0.05). EGG-HNR and EGG-SNR in larynx leukoplakia group were lower than those in normal group. Furthermore, CQP and CIP in larynx leukoplakia group were higher than those normal group with statistically significant difference (P<0.05). Most patients’(72.9%) EGG waveform showed gradually ac?celerate phase velocity and fast close phase, which represent a spike-like shape. Conclusion Voice acoustic analysis com?bined with EGG provide objective indicators to assess degree of hoarseness, and to provide sonic evidences for prevention, recurrence, assessment and pronunciation correction of the larynx leukoplakia.
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Objective To investigate the aerodynamic characteristics of vocal polyps and vocal nodules.Methods Aerodynamic parameters of 58 patients with vocal polyps or vocal nodules and 30 normal adults were measured by Aerophone Ⅱ Voice Function Analyzer.The mean airflow rate,intraoral pressure,glottal resistance,glottal efficiency were compared among different group.Results The mean airflow rate,glottal resistance and glottal efficiency of vocal polyps,vocal nodules and normal adult were 254.50±36.02 ml/s,33.55±4.63 cmH_2O/(L·S),2.46±1.49,177.45±25.93 ml/s,38.83±8.88 cmH_2O/(L·S),7.75±3.71,118.44±29.98 ml/s,53.04±8.64 cmH_2O/(L·S),9.17±3.87,respectively.The difference between them was significant(P＜0.01).The difference of intraoral pressure between vocal polyps (8.97±1.36 cmH_2O) and normal adult (6.24±0.99 cmH_2O) was significant (P＜0.01).The mean airflow rate,glottal resistance,glottal efficiency were significantly different between vocal polyps and vocal nodules(P＜0.01).Conclusion The degree of vocal fold adduct and the effciency of voice production in vocal polyps is worse than that of vocal nodules.The aerodynamic parameters can make quantifiable,objective assessment in voice function of vocal polyps and vocal nodules.
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OBJECTIVE@#To explore the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carcinoma.@*METHOD@#Retrospectively study 91 patients with glottic carcinoma (9 Tis, 45 pT1a, 25 pT1b, 12 pT2) treated in our department from October 1999 to August 2004. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society in 2000.@*RESULT@#According to the Kaplan-Meier method, the probability of remaining free of local recurrence 5 years after primary surgery alone was 100.00% for the Tis, 93.33% for the T1a, 84.00% for T1b and 75.00% for the T2 respectively, without statistical significance of various groups by the Log-Rank tests (P > 0.05). The probability of remaining free of local recurrence 5 years after primary surgery alone was 78.57% (6/28) of tumors offended the anterior commissure, versus 93.65% (4/63) with no involvement of anterior commissure, have statistical significance (P < 0.01). The 5 year overall survival and the disease free survival were 92.72% and 84.62% respectively. Perceptive evaluation was performed with the "GRBAS" evaluation system 6 month after laser operation. All patients in the group of type I and type II had an normal voice or mild dysphonia. The patients treated with type III, type IV and type V had a mild or moderate vocal disease.@*CONCLUSION@#According to the present series, endoscopic CO2 laser surgery is an effective treatment for early glottic cancer.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , General Surgery , Laryngeal Neoplasms , General Surgery , Laryngectomy , Methods , Lasers, Gas , Microsurgery , Retrospective Studies , Vocal CordsABSTRACT
OBJECTIVE To analyze the complications of the CO2 laser-assisted laryngeal microsurgery for laryngeal tumors. METHODS The clinical data of 520 patients who underwent CO2 laser assisted laryngeal microsurgery for laryngeal tumors were retrospectively analyzed. The complications were recorded. RESULTS Complications caused by CO2 laser were found in 61 case(11.73 %) and those caused by suspended laryngoscope in 71 case(13.65 %). CONCLUSION The complications of the CO2 laser-assisted laryngeal microsurgery for laryngeal tumors may be caused by CO2 laser or suspended laryngoscope.