Evaluation Of The Voice And Psychological Status Of Patients With Benign And Malignant Vocal Cord Lesions

Objective The diagnosis and treatment process of voice disease is quite complicated whicis closely related to the psychology and life of patients.Many etiologies can lead abnormalities of the voice such as congenital malformations,inflammatory lesions,benigand malignant tumors,etc.The gold standard for the diagnosis of pathological lesions the vocal cords is tissue biopsy,which requires a higher degree of cooperation for patientand its invasive nature limits its use.The purpose of this study is to evaluate the voice anmental state of patients with benign vocal cord lesions and malignant vocal cord lesionand to explore its clinical significance in the diagnosis and treatment of patients wibenign and malignant vocal cord lesions,so as to provide a certain reference for clinicpractice.Methods 1.Experimental groups:(1)Benign lesions of the vocal cords: A total of 48 patients who were found to have organic lesions of the vocal cords by stroboscopic laryngoscopy and pathologically diagnosed as benign lesions of the vocal cords at the Department of Otolaryngology,head and neck surgery,the Affiliated Hospital of Qingdao University from August 2018 to December 2020 due to hoarseness were collected.(2)Malignant lesions of the vocal cords group: A total of 35 patients who were found to have organic lesions of the vocal cords and pathologically diagnosed with malignant lesions of the vocal cords by stroboscopic laryngoscopy at the Department of Otolaryngology,head and neck surgery,Affiliated Hospital of Qingdao University from August 2018 to December 2020 due to hoarseness were collected.2.Control group: The healthy examiners and volunteers without dysarthria at the Affiliated Hospital of Qingdao University from August 2018 to December 2020 were collected,and 41 cases were set as the control group,all of them were normal people with no abnormal voice.The included groups were matched for patient age and sex distribution.All patients were evaluated by computerized voice assessment,GRBAS assessment,VHI scale,dynamic laryngoscopy,PHQ-9 and the GAD-7,and the results of each index were evaluated between the groups.Results 1.There was a significant difference in total hoarseness between the benign and malignant lesions of the vocal cords,P < 0.01.2.The total score between benign lesions of the vocal cords and malignant lesions of the vocal cords group was statistically different,and there were statistically significant differences in functional aspects,living aspects,and emotional aspects.3.Reduced mucosal waves and incomplete vocal fold closure were found in the majority of patients with benign vocal fold lesions,and were dominated by mildly reduced mucosal waves and mild vocal fold insufficiency.In the malignant lesions of the vocal cords group,significant mucosal wave attenuation could be observed under stroboscopic laryngoscopy,which was dominated by severe attenuation and disappearance of mucosal wave on the affected side,and the symmetry and periodic presentation irregularity of mucosal wave vibration in the vocal cords were obvious.According to the scores of each index,the condition of mucosal wave,the condition of vocal fold closure,the symmetry of the mucosal amplitude of the vocal cords,and the periodicity of vibration of the vocal cords in the group with benign and malignant lesions of the vocal cords were statistically significant compared with those of the control group,and the values were significant at P <0.01.4.Benign lesions of the vocal cords,malignant lesions of the vocal cords all patients had obvious abnormalities in the computer voice analysis indexes,frequency perturbation,amplitude perturbation as well as the longest sound.There were significant differences in the frequency perturbations,as well as in the longest sound,between the group with benign vocal cord lesions and the control group;the amplitude perturbations between the two groups,however,were not significantly different,P<0.05.There were significant differences between the malignant lesions of the vocal cords and the control group in the frequency perturbations,amplitude perturbations,and longest sound durations,P < 0.01.There were significant differences in the frequency perturbations,amplitude perturbations,and longest sound between the benign and malignant lesions of the vocal cords with P <0.01.5.There was no statistical difference in PHQ-9 and GAD-7 scores between patients with benign vocal cord lesions and controls,P > 0.05.The PHQ-9 and GAD-7 scores were significantly different between the malignant lesions of the vocal cords and the control group,P < 0.01.The PHQ-9 and GAD-7 scores were significantly different between the benign and malignant lesions of the vocal cords,P < 0.01.Conclusions: 1.All the indicators of subjective assessment and objective detection of voice have an important role in the diagnosis and treatment of benign and malignant lesions of vocal cords.2.A well-established assessment of the voice and mental status will be important in the diagnosis and treatment of patients with benign and malignant lesions of the vocal cords.Objective We aimed to explore the clinical importance of voice and mental state assessment in the diagnosis and treatment of functional speech disorders.Methods We selected 72 patients with functional dysphonia(experimental group)and40 individuals without dysphonia(control group)from the Department of Otolaryngology,Affiliated Hospital of Qingdao University,from August 2017 to October 2020.In the functional dysphonia group,50 individuals had enhanced dysphonia and 22 had diminished dysphonia.All patients underwent voice assessment,evaluation using the Grade,Roughness,Breathiness,Asthenia,Strain(GRBAS)scale and voice handicap index(VHI)scale,dynamic laryngoscopy,and evaluation of anxiety(Self–Rating Anxiety Scale,SAS)and depression(Self–Rating Depression Scale,SDS).We compared evaluation results of the various indicators between the two groups.Results In the experimental group,the GRBAS score was 1.92 ± 1.03 and the VHI score was 58.43±23.17.Vocal cord closure,mucosal wave,symmetry,and periodicity scores in the experimental group were significantly different from those of the control group,in stroboscopic examination.In computer voice evaluation,the frequency perturbation,amplitude perturbation,and maximum sound time in the experimental group were significantly different from these values of the control group.We found significant differences in SAS and SDS scores between the experimental and control groups.Conclusion Voice and mental state assessment are important for guiding the diagnosis and treatment of patients with functional phonation disorder.