CLINICO-FUNCTIONAL ASSESSMENT OF THE EFFECTIVENESS OF SURGICAL VOICE RESTORATION BASED ON THE INTEGRAL SCORING SYSTEM OF VIDEOLARYNGOSTROBOSCOPY
DOI:
https://doi.org/10.37219/mfcngg72Keywords:
videolaryngostroboscopy, integral scoring system, organic laryngeal pathology, vocal folds, voice restoration, rehabilitationAbstract
Abstract
Introduction. Voice production is critically important for human vital activity and professional fulfillment. Impairment of this function due to functional or organic laryngeal diseases leads to a significant restriction of communication capabilities. Videolaryngostroboscopy plays a crucial role in the diagnosis of such disorders, allowing for an objective assessment of vocal fold kinetics and vibratory properties using pulsed illumination.
Objective. To assess the functional state of the larynx using videolaryngostroboscopy data in patients with organic pathology during the course of treatment.
Materials and Methods. A total of 79 patients with organic laryngeal pathology (benign vocal fold lesions: nodules, fibromas, cysts) were examined before and at various intervals after surgical treatment. Depending on the effectiveness of postoperative voice recovery, the patients were divided into two groups: Group 1 included 61 patients with complete voice restoration; Group 2 included 18 patients with an unsatisfactory level of voice re-education. The comprehensive examination involved indirect laryngoscopy and videolaryngostroboscopy using "Karl Storz" (Germany) equipment, utilizing a developed system of integral scoring for 6 main parameters of phonatory vibrations.
Results. Prior to treatment, all patients exhibited pronounced vocal fold hypotonus, muscle coordination disorders, and asynchronous vibrations, with the mucosal wave being predominantly absent; the mean integral score was 8.4 ± 0.2. On the 10th day after surgery, the score in the total group decreased to 6.7 ± 0.2, and reached 5.6 ± 0.3 after 1 month (compared to 5.01 ± 0.01 in the control group). In Group 1 patients, complete restoration of laryngeal vibratory function and stable "stroboscopic comfort" were recorded, which was confirmed by the absence of a statistically significant difference compared to the control group after 1 month. Concurrently, in Group 2 patients, laryngeal dysfunction, vibration asynchrony, and the absence of complete vocal fold closure persisted even after a month (mean score 6.3 ± 0.4, p < 0.05 compared to the control group).
Conclusions. Videolaryngostroboscopy is a highly informative method that is crucial for the accurate determination of the functional state of the larynx. Quantitative evaluation using integral scores allows for the objective verification of hidden phonatory disorders and the prediction of the course of postoperative rehabilitation. Given identical morphological characteristics of the lesion, voice restoration depends to a greater extent on the preservation of the vibratory cycle rather than on anatomical structural changes visible during standard laryngoscopy.
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