声音改变的临床病理研究

Arifuzzaman, S. N. Fattah, Mohammad Nazrul Islam, M. Hasan, Monirul Islam, C. Tabassum, S. Monira, Sardar Mohammad Tanvir, Mohammad Farhad
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摘要

背景:音变是耳鼻喉科常见的主诉之一,声音嘶哑是音质改变最常见的症状。声音嘶哑总是直接或间接影响发声器官的最早表现。虽然声音嘶哑最常见的原因是良性的,其中最常见的是声音滥用,但我们应该经常调查更险恶的病理,如恶性肿瘤。目的:了解引起声音改变的症状、体征及病理发生率,为早期诊断和介入治疗提供依据。方法:选取2016年1月1日至2016年6月30日在达卡医学院附属医院耳鼻喉科头颈外科住院的86例变声患者,历时6个月。采用有目的抽样的方法,根据入选标准选取病例。然后,通过预先编制的数据收集表,对受访患者积极参与进行数据收集。结果:声带病变以喉癌为主(37.93%),其次为慢性喉炎(20.99%),其次为声带小结(19.54%)和声带息肉(8.05%)。45.95%的慢性喉炎患者存在咽喉反流。男性多于女性(1.81:1)。大多数患者年龄在21 ~ 50岁之间。发病率高峰出现在第四个十年。劳动者/日薪劳动者构成了主要群体。大多数患者来自低社会经济阶层。吸烟、言语虐待、吸烟和感染是常见的诱发因素。结论:声音嘶哑是一种病因多样的症状。病因学资料在不同的地理位置和不同的中心有所不同,因此每个病例都应仔细和彻底地评估,以了解诊断和潜在病理,以便及早和及时处理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinicopathological Study of Change of Voice
Background: Change of voice is one of the common complaints in ENT practice and hoarseness of voice is the commonest symptom of changed voice quality. Hoarseness is invariably the earliest manifestation of conditions directly or indirectly affecting the voice apparatus. Though most common causes of hoarseness are benign and vocal abuse is the commonest among them, but we should always investigate for more sinister pathology like malignancy. Objectives: To find out the symptoms, signs and pathological incidence, leading to change of voice for early diagnosis and interventional purpose. Methods: Total 87 patients of change of voice, studied in 06 months duration from 1 January 2016 to 30 June 2016 in the Department of ENT & Head-Neck Surgery, Dhaka Medical College Hospital, Dhaka. The cases were selected according to the eligibility criteria by purposive sampling. Then the data were collected by the active participation of the patients interviewed by the preformed proforma of data collection sheet. Results: Maximum number of cases of change of voice were due to carcinoma larynx (37.93%), then chronic laryngitis (20.99%), followed by vocal cord nodules (19.54%) and vocal cord polyps (8.05%.). Laryngopharyngeal reflux was found in 45.95% patients of chronic laryngitis. Males were affected more than females (1.81:1). Most of the patients were in the age group of 21 to 50 years. Peak incidence was in the 4th decade. Labourers/ daily wage earners formed the predominant group. Majority of patients were from low socioeconomic class. Smoking, vocal abuse, smoking and infections were the common predisposing factors. Conclusion: Hoarseness of voice is just a symptom with a very diverse etiology. The etiological data varies in different geographical location and from one center to other, so every case should be carefully and thoroughly evaluated to know the diagnosis and underlying pathology for early and prompt management.
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