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. 2017 Aug;37(4):286-294.
doi: 10.14639/0392-100X-1035.

Stabilometric findings in patients affected by organic dysphonia before and after phonomicrosurgery

A Nacci  1 , S O Romeo  1 , S Berrettini  1   2 , J Matteucci  1 , M D Cavaliere  1 , V Mancini  1 , E Panicucci  3 , F Ursino  4 , B Fattori  1
Affiliations

Stabilometric findings in patients affected by organic dysphonia before and after phonomicrosurgery

A Nacci et al. Acta Otorhinolaryngol Ital. 2017 Aug.

Abstract
in English, Italian

The purpose of this study is to understand if there is any alteration in the posture of patients affected by organic dysphonia and describe possible postural modifications after phonomicrosurgery on the vocal folds. Forty subjects (22 males, 18 females; mean age 32.6 ± 7.5 years) suffering from organic dysphonia (15 cases of polyps, 11 submucosal retention cysts, 10 bilateral fibrous vocal fold nodules and 4 bilateral Reinke's oedema) were examined by open-eye and closed-eye posturography while breathing spontaneously before surgery, 24 hours after surgery and after 6 months. The variables taken into account were: the coordinates of the centre of pressure on both frontal and sagittal planes, length and surface of the track, mean velocity of the oscillations and relative standard deviations, spectral analysis of oscillation frequency, statokinesigram and stabilogram values. No characteristic pathological pattern was seen in basal stabilometry in any of the subgroups (polyps, cysts, Reinke's oedema). Only the subgroup of patients with fibrous vocal fold nodules (8/10; 80%) showed a slight forward shift from the centre of gravity when analysed in both open-eye and closed-eye posturography. A comparison performed within the same subgroup using open-eye and closed-eye posturography before and after surgery revealed no significant difference in any of the parameters being studied. The use of static stabilometry in this study demonstrates the absence of characteristic postural alterations in patients affected by organic dysphonia and also excludes that simple removal of the vocal fold lesion can change posture.

Lo scopo di questo studio è stato quello di dimostrare se pazienti affetti da disfonia organica presentino alterazioni posturali caratteristiche e se l’intervento di fonomicrochirurgia delle corde vocali determini modificazioni dell’assetto posturale. Sono stati esaminati 40 soggetti (22 maschi, 18 femmine; età media 32,6 ± 7,5 anni) affetti da disfonia organica (15 polipi cordali, 11 cisti da ritenzione sottomucosa, 10 noduli vocali fibrosi bilaterali e 4 edema di Reinke). L’assetto posturale è stato studiato mediante stabilometria statica in respirazione spontanea, ad occhi aperti e ad occhi chiusi, in tre diverse fasi: prima dell’intervento chirurgico, 24 ore dopo la chirurgia e 6 mesi dopo l’intervento. Le variabili prese in considerazione sono state: le coordinate del centro di pressione sul piano frontale e sagittale, la lunghezza e la superficie della traccia, la velocità media delle oscillazioni e le relative deviazioni standard, l’analisi spettrale della frequenza di oscillazione e i valori di statokinesigramma e stabilogramma. Nessun pattern patologico caratteristico veniva rilevato alla stabilometria in condizioni basali nei diversi sottogruppi di pazienti (polipi, cisti, edema di Reinke). Solo il sottogruppo di pazienti con noduli vocali bilaterali fibrosi (8/10; 80%) mostrava un lieve spostamento in avanti del centro di gravità sia ad occhi aperti che ad occhi chiusi. In tutti i sottogruppi non si verificavano modificazioni significative delle variabili stabilometriche ad occhi aperti e ad occhi chiusi, prima e dopo l’intervento chirurgico. L’uso della stabilometria statica, in questo studio, dimostra l’assenza di alterazioni posturali caratteristiche nei casi di disfonia organica ed esclude che la semplice rimozione della lesione cordale, unilaterale o bilaterale, possa determinare variazioni posturali.

Keywords: Organic voice disorders; Phonomicrosurgery; Posture; Proprioception; Static stabilometry.

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Figures

Fig. 1.
Fig. 1.
Stabilometric finding (statokinesigram) of a patient with submucosal retention cyst in the closed-eye mode in basal conditions (A), 24 h after phonomicrosurgery (B) and 6 months after surgery (C). No characteristic pathological pattern was seen in basal conditions; a comparison performed before and after surgery (after 24h and after 6 months), revealed no significant difference in the statokinesigram pattern.
See this image and copyright information in PMC

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