갑상선 절제 술 후 기능적 음성장애의 공기역학적 특징과 음성치료 중재

Aerodynamic Features and Voice Therapy Interventions of Functional Voice Disorder after Thyroidectomy

  • 이창윤 (동남권원자력의학원 이비인후과) ;
  • 안수연 (동남권원자력의학원 이비인후과) ;
  • 장현 (동남권원자력의학원 이비인후과) ;
  • 정희석 (양산부산대학교병원) ;
  • 손희영 (동남권원자력의학원 이비인후과)
  • Lee, Chang-Yoon (Department of Otorhinolaryngology, Dongnam Institute Of Radiological & Medical Sciences) ;
  • An, Soo-Youn (Department of Otorhinolaryngology, Dongnam Institute Of Radiological & Medical Sciences) ;
  • Chang, Hyun (Department of Otorhinolaryngology, Dongnam Institute Of Radiological & Medical Sciences) ;
  • Jeong, Hee Seok (Pusan National University Yangsan Hospital) ;
  • Son, Hee Young (Department of Otorhinolaryngology, Dongnam Institute Of Radiological & Medical Sciences)
  • 투고 : 2015.05.19
  • 심사 : 2015.05.25
  • 발행 : 2015.06.01

초록

Background and Objectives:The objective of this study was to investigate the features of post-thyroidectomy subjective voice disorder by Voice Handicap Index (VHI) and Voice Symptom Scale (VOISS) through aerodynamic analysis and to investigate the appropriate voice therapy intervention. Materials and Methods:Twenty post-thyroidectomy patients who had no recurrent laryngeal nerve paralysis through laryngeal stroboscopy were enrolled for this study. Acoustic and aerodynamic evaluations were performed before operation, 2 weeks and 3 months after operation. Subjective voice evaluation was performed by VHI and VOISS. Aerodynamic evaluation was compared and analysed by maximum phonation time(MPT), phonation threshold pressure(PTP), mean air flow rate(MFR), etc. Subjective voice evaluation was surveyed through VHI and VOISS. To evaluate patients' symptoms related to functional voice disorder, scores on physical domain in VHI and VOISS were selected to be compared for each session. Results: The 10 out of 20 participants who complained of voice symptoms had no significant difference with pre-operation in acoustic evaluation, but all showed higher scores on 2 weeks and 3 months after operation compared to pre-operation, in VHI-physical domain and selected questionnaires in VOISS. They reduced MPT and increased PTP value simultaneously. Laryngeal massage and breathing training were simultaneously treated to them, 5 participants resulting in improvement in MPT and PTP compared to pre-treatment. Conclusion:Patients who complained voice change with no organic damage after thyroidectomy were all shown to have reduced MPT and increased PTP in some by aerodynamic evaluations. Reduced MPT may imply some problem in air flow beneath glottis. Increased PTP suggests much more effort in vocalization mechanism than pre-operation. Comparing aerodynamic evaluations in post-thyroidectomy may provide information on behavioral interventions. Additionally, study on laryngeal massage and breathing training simultaneously treated to patients with such voice disorder is needed to be conducted with larger number of participants.

키워드

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