Hardly any studies have been conducted in South Indian population to
August 29, 2017
Hardly any studies have been conducted in South Indian population to evaluate glottic function and voice outcome following carbon dioxide (CO2) laser assisted microsurgery for benign lesions of the larynx. a significant improvement in the GRBAS score after surgery (p?0.001). Acoustic analysis showed that all the parameters improved significantly after surgery (p?0.001). Stroboscopy showed that vocal fold function improved IEGF in 98?% of patients in terms of completeness of glottic closure and regular, periodic mucosal wave. Super-pulse micro-spot carbon dioxide laser is a safe and effective treatment option for benign lesions of vocal folds, with excellent voice outcome. test was used. MannCWhitney U-test was used for comparing non-Gaussian variables between the sub-groups. p Tubacin IC50 value <0.05 was considered Tubacin IC50 as significant. The study was approved by the Institute Research Council and Tubacin IC50 the Institute Ethics Committee. Results The present study consisted Tubacin IC50 of 50 patients who underwent carbon dioxide laser excision for various benign lesions of vocal fold. The mean age of the study population was 43?years with a standard deviation of 11.847. The youngest patient in the study was 19?years and the eldest was 67?years. The overall male:female ratio in the study population was 1.9:1. The maximum number of patients was found in the age group 31C40. Types of Lesions The most common lesion that was found in our study was vocal polyp, in 40?% (20 patients). The most common lesion in males was vocal polyp (42?%). In females both polyps and nodules were seen with equal frequency (35?%). The least common lesion was keratosis larynx, which was seen only in men (Table?1). Table?1 Vocal fold lesionsgender-wise distribution Symptomatology and Clinical Evaluation All patients in the study population presented with the chief complaint of hoarseness of voice. The second most common complaint was strain while speaking, which was present in 25 patients (50?%). History of vocal fatigue was given by 23 patients (46?%). A total of 19 patients (38?%) gave history of voice abuse, of which 13 were males and 9 were females. Only two patients (4?%) gave history of previous laryngeal surgery, both of whom were diagnosed with Recurrent Laryngeal Papillomatosis. There were 12 patients in the study who were smokers and had quit smoking at the time of diagnosis. History suggestive of gastro-esophageal reflux was present in 12 patients (24?%). The symptomatology is depicted in Table?2. Table?2 Distribution of symptoms and relevant history in the study population Perceptual Evaluation Perceptual voice analysis was done by a speech pathologist using GRBAS score. The pre-operative median GRBAS score was 9 with a range of 6C13. The median score improved to 6 by the second post-operative follow up visit. There was consistent improvement in the GRBAS score in all post-operatives (Table?3). By the last follow-up visit, i.e. in the third month, the median GRBAS score was 2. Repeated measures of ANOVA was used to analyse the data. Tubacin IC50 There improvement in the mean GRBAS score after the surgery and at each post-operative visit was found to be significant (p?0.001). The analysis also revealed significant difference between mean scores at each follow-up visit (p?0.001). Table?3 Median GRBAS scores with range at each visit Acoustic Analysis Voice quality before and after surgery was evaluated by electroacoustic voice recording and spectrographic analysis of fundamental frequency (F0), jitter, shimmer, and HNR using PRAAT software. The acoustic parameters were analysed separately for males and females using repeated measures analysis of variance. The mean pre-operative fundamental frequency (F0) for females was 193.04?Hz, which increased to 223.06?Hz at the third month. For males, the fundamental frequency changed from 140.7?Hz in the pre-operative period to 125.65?Hz at the third follow up (Table?4). F0 was analysed using repeated measures analysis of variance, which showed significant difference in the pre- and each follow-up F0 values (p?0.0001). There was, however no significant difference among the F0 values of each follow-up visit (p?>?0.05). Table?4 Distribution of fundamental frequency (F0)mean with SD The pre-operative mean shimmer was 10.8?% in both males and females, which reduced to 4.6?% in males and 5.0?% in females by the third follow-up visit (Table?5). There was significant improvement in shimmer values following surgery, compared with pre-operative measurements (p?0.001). There was significant difference in the mean shimmer values between each follow-up visit (p?0.001). Table?5 Distribution of Shimmer, Jitter and HNRmean with SD The pre-operative mean jitter.