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目的:通过对内镜鼻窦手术(ESS)前后鼻音及鼻腔阻力的客观检测,探讨ESS后鼻腔鼻窦共鸣特性的改变及鼻腔阻力的变化特点。方法:对资料记录完整的68例成人鼻息肉鼻窦炎患者,ESS前后使用鼻声图仪和鼻压计分别对鼻音和鼻阻力进行检测。结果:Ⅲ型和Ⅱ型2期、3期患者术后1个月鼻音均明显改善(均P<0.05),但仍低于正常值;术后3个月,Ⅱ型2期、3期鼻音达正常值下限,Ⅲ型仍未恢复正常;而总鼻阻力在术后1个月明显下降(P<0.01),术后3个月恢复正常。Ⅱ型1期患者术后1个月鼻音和总鼻阻力即恢复正常,其值与术前比较,差异无统计学意义(P>0.05)。结论:对于严重的鼻窦或(和)鼻腔病变的患者ESS术后1个月总鼻阻力明显改善,接近正常范围,而鼻音在较长一段时间里仍表现异常。提示ESS术后不能立即改善鼻音状况,相反过多破坏鼻腔、鼻窦正常结构,使鼻腔、鼻窦的共鸣特性发生改变,这对从事语音工作(如播音员、外语及语言老师等)的人可能有较大影响。
OBJECTIVE: To investigate the changes of nasal sinus resonance and nasal resistance after ESS through objective examination of nasal and nasal resistance before and after endoscopic sinus surgery (ESS). Methods: A total of 68 adult patients with nasal polyps were enrolled in this study. Nasal sound and nasal resistance were measured before and after ESS using nasal sonograph and sphygmomanometer respectively. Results: The nasal sounds of Grade II and III patients in stage 2 and stage 3 were significantly improved (all P <0.05) at 1 month after operation, but still lower than normal values. At 3 months after operation, type 2, stage 3 nasal sounds Reached the lower limit of normal, type Ⅲ has not returned to normal; and total nasal resistance decreased significantly at 1 month after operation (P <0.01), 3 months after the return to normal. Nasal tone and total nasal resistance returned to normal at 1 month after operation in type Ⅱ 1 patients. The difference was not statistically significant (P> 0.05). CONCLUSIONS: Total nasal resistance at one month post ESS was significantly improved in patients with severe sinuses or (and) nasal lesions, approaching the normal range, while nasal sounds remained abnormal for an extended period of time. It is suggested that nasal sounds can not be improved immediately after ESS. On the contrary, the normal structure of nasal and sinus is destroyed too much, which may change the resonance characteristics of nasal and sinus. This may be useful to those engaged in voice work (such as announcers, foreign languages and language teachers) Great impact.