medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2022-008medsovet-7280Research ArticleДИССЕРТАНТDISSERTANTХронический отечно-полипозный ларингит (болезнь Рейнке – Гайека) как причина охриплости. Персонифицированный подход к хирургическому лечениюChronic edematous-polypous laryngitis (Reinke – Gayek disease) as a cause of hoarseness. Personalized approach to the surgical treatmenthttps://orcid.org/0000-0003-3390-8288АбдуллаевБ. З.AbdullaevB. Z.

Абдуллаев Башир Зиявутдинович - младший научный сотрудник научно-клинического отдела заболеваний верхних дыхательных путей.

123182, Москва, Волоколамское шоссе, д. 30, корп. 2

Bashir Z. Abdullaev - Junior Researcher at the Clinical Department of Upper Respiratory Pathology, The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia.

30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182

boxich1985@mail.ruhttps://orcid.org/0000-0002-4302-5203НажмудиновИ. И.NazhmudinovI. I.

Нажмудинов Ибрагим Исмаилович – доктор медицинских наук, руководитель научно-клинического отдела заболеваний верхних дыхательных путей.

123182, Москва, Волоколамское шоссе, д. 30, корп. 2

Ibragim I. Nazhmudinov - Dr. Sci. (Med.), Head of the Scientific and Clinical Pathology of the Upper Respiratory Tract, The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia.

30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182

https://orcid.org/0000-0002-2887-0652ДавудовХ. Ш.DavudovK. S.

Давудов Хасан Шахманович - доктор медицинских наук, профессор, первый заместитель директора, заслуженный врач РФ.

123182, Москва, Волоколамское шоссе, д. 30, корп. 2

Khasan Sh. Davudov - Dr. Sci. (Med.), Professor, First Deputy Director, Honored Doctor of the Russian Federation, The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia.

30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182

https://orcid.org/0000-0002-5024-6135ГаращенкоТ. И.GarashchenkoT. I.

Гаращенко Татьяна Ильинична - доктор медицинских наук, профессор, ученый секретарь.

123182, Москва, Волоколамское шоссе, д. 30, корп. 2

Tatiana I. Garashchenko - Dr. Sci. (Med.), Professor, Scientific Secretary, The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia.

30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182

ГусейновИ. Г.GuseynovI. G.

Гусейнов Исмаил Гасанович – кандидат медицинских наук, младший научный сотрудник научно-клинического отдела заболеваний верхних дыхательных путей.

123182, Москва, Волоколамское шоссе, д. 30, корп. 2

Ismail G. Guseynov - Cand. Sci. (Med.), Junior Researcher at the Clinical Department of Upper Respiratory Pathology, The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia.

30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182

ismail1982@mail.ruhttps://orcid.org/0000-0002-4549-9074ХорановаМ. Ю.KhoranovaM. Y.

Хоранова Марина Юрьевна - младший научный сотрудник научно-клинического отдела заболеваний верхних дыхательных путей.

123182, Москва, Волоколамское шоссе, д. 30, корп. 2

Marina Y. Khoranova - Junior Researcher at the Clinical Department of Upper Respiratory Pathology, The National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia.

30, Bldg. 2, Volokolamskoe Shosse, Moscow, 123182

marina17.03@mail.ruНациональный медицинский исследовательский центр оториноларингологии Федерального медико-биологического агентства РоссииРоссияThe National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of RussiaRussian Federation20231104202304169176Copyright © Абдуллаев Б.З., Нажмудинов И.И., Давудов Х.Ш., Гаращенко Т.И., Гусейнов И.Г., Хоранова М.Ю., 20232023Абдуллаев Б.З., Нажмудинов И.И., Давудов Х.Ш., Гаращенко Т.И., Гусейнов И.Г., Хоранова М.Ю.Abdullaev B.Z., Nazhmudinov I.I., Davudov K.S., Garashchenko T.I., Guseynov I.G., Khoranova M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7280Введение

Введение. Хронический отечно-полипозный ларингит, или отек Рейнке – Гайека, составляет 5,5% от всех доброкачественных заболеваний голосовых складок. Хирургическое лечение болезни Рейнке – Гайека заключается в удалении избытков слизистой оболочки либо в срывании полоски слизистой щипцами с голосовой складки – «стриппинг». Принципом хирургии гортани является сохранение структур голосовой складки, получение гибкой вибрации мышечно-мембранозной части и слизистой оболочки голосовой складки.

Цель

Цель. Изучить возможность повышения эффективности лечения больных с отеком Рейнке – Гайека путем разработки щадящих методов хирургического лечения с использованием углекислого лазера и выработать критерии выбора в зависимости от типа отека по классификации H. Yonekawa.

Материалы и методы

Материалы и методы. Пролечено 80 пациентов с болезнью Рейнке – Гайека, 59 женщин и 21 мужчина, от 29 до 77 лет, разделенных на две подгруппы и контрольную группу. Предоперационное обследование включало эндоскопический осмотр, ларингостробоскопию. Определяли тип по классификации H. Yonekawa. При II типе, подгруппа 1 – аспирационная методика, n = 30. При III типе, подгруппа 2 – М-образная методика, n = 30. Контрольная группа: в нее входят пациенты с II и III типом отека, резекционная методика, n = 20.

Результаты

Результаты. Пациентам в предоперационном периоде проводилось анкетирование опросником SF-36 Health Status Survey, индекс тяжести дисфонии (DSI), а также время максимальной фонации. Осматривали через 1 и 6 мес. после операции. Отмечается прирост показателей, увеличение времени максимальной фонации, увеличение баллов SF-36.

Выводы

Выводы. Применение данной методики позволило существенно ускорить восстановление голоса, сократить время нахождения в стационаре, минимально повреждая структуру слизистой оболочки голосовых складок.

Introduction

Introduction. Chronic edematous-polypous laryngitis, Reinke – Gayek’s edema accounts for 5.5% of all benign diseases of the vocal folds. Surgical treatment of Reinke – Gayek disease consists in removing excess mucosa, or “stripping” – tearing off a strip of mucosa with forceps from the vocal fold. The principle of laryngeal surgery is to preserve the structures of the vocal fold, to obtain flexible vibration of the muscular-membranous part and the mucous membrane of the vocal fold.

Purpose

Purpose. Improving the effectiveness of the treatment of patients with Reinke – Hayek edema by developing sparing methods of surgical treatment using a carbon dioxide laser. To develop criteria for choosing a method of sparing surgical treatment of Reinke – Hayek edema using a carbon dioxide laser, depending on the type of edema according to the Yonekawa classification.

Materials and methods

Materials and methods. 80 patients with Reinke – Gayek’s disease, 59 women and 21 men, from 29 to 77 years old, divided into two subgroups, and a control group were treated. Preoperative examination included endoscopic examination, laryngostroboscopy. The type was determined according to the H. Yonekawa classification. In type II, subgroup 1 – aspiration technique, n = 30. In type III, subgroup 2 – M-shaped technique, n = 30. Control group, it includes patients with type II and III edema, resection technique, n = 20.

Results

Results. Patients in the preoperative period were surveyed with the SF-36 Health Status Survey questionnaire, the dysphonia severity index (DSI), as well as the time of maximum phonation. In the postoperative period, they were examined, 1 month after the operation and 6 months after the operation. There is an increase in indicators, an increase in the time of maximum phonation, an increase in SF-36 scores.

Conclusion

Conclusion. The use of this technique made it possible to significantly accelerate the recovery of the voice, reduce the time spent in the hospital, minimally damaging the structure of the mucous membrane of the vocal folds.

отек РейнкеСО2-лазерSF-36 Health Status SurveyDSIвремя максимальной фонацииedema ReinkeCO2 laserSF-36 Health Status SurveyDSImaximum phonation timeReferencesKambic V., Gale N., Radsel Z. Anatomical markers of Reinke’s space and the etiopathogenesis of Reinke edema. Laryngorhinootologie. 1989;68(4):231–235. Available at: https://pubmed.ncbi.nlm.nih.gov/2662985.Kambic V., Gale N., Radsel Z. Anatomical markers of Reinke’s space and the etiopathogenesis of Reinke edema. Laryngorhinootologie. 1989;68(4):231–235. Available at: https://pubmed.ncbi.nlm.nih.gov/2662985.Remacle M., Eckel H.E. (eds.). Surgery of Larynx and Trachea. Springer Berlin, Heidelberg; 2010. 308 p. https://doi.org/10.1007/978-3-540-79136-2.Remacle M., Eckel H.E. (eds.). Surgery of Larynx and Trachea. Springer Berlin, Heidelberg; 2010. 308 p. https://doi.org/10.1007/978-3-540-79136-2.Steiner W., Fagan J. Transoral laser microsurgery (TLM) of cancer & other pathology of the upper aerodigestive tract. In: Fagan J. (ed.). The Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery. University of Cape Town; 2017. https://doi.org/10.15641/0-7992-2534-1.Steiner W., Fagan J. Transoral laser microsurgery (TLM) of cancer & other pathology of the upper aerodigestive tract. In: Fagan J. (ed.). The Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery. University of Cape Town; 2017. https://doi.org/10.15641/0-7992-2534-1.Nerurkar N., Narkar N., Joshi A., Kalel K., Bradoo R. Vocal outcomes following subepithelial infiltration technique in microflap surgery: a review of 30 cases. J Laryngol Otol. 2007;121(8):768–771. https://doi.org/10.1017/S002221510700744X.Nerurkar N., Narkar N., Joshi A., Kalel K., Bradoo R. Vocal outcomes following subepithelial infiltration technique in microflap surgery: a review of 30 cases. J Laryngol Otol. 2007;121(8):768–771. https://doi.org/10.1017/S002221510700744X.Raluca T., Melin T. Reinke’s Edema. Otolaryngol Clin North Am. 2019;52(4):627–635. https://doi.org/10.1016/j.otc.2019.03.006.Raluca T., Melin T. Reinke’s Edema. Otolaryngol Clin North Am. 2019;52(4):627–635. https://doi.org/10.1016/j.otc.2019.03.006.Arroyo H.H., Neri L., Fussuma C.Y., Imamura R. Diode Laser for Laryngeal Surgery: a Systematic. Int Arch Otorhinolaryngol. 2016;20(02):172–179. https://doi.org/10.1055/s-0036-1579741.Arroyo H.H., Neri L., Fussuma C.Y., Imamura R. Diode Laser for Laryngeal Surgery: a Systematic. Int Arch Otorhinolaryngol. 2016;20(02):172–179. https://doi.org/10.1055/s-0036-1579741.Hatayama H., Kato J., Inoue A., Akashi G., Hirai Y. Comparison of violet diode laser with CO2-laser in surgical performance of soft tissues. Proc. SPIE. 2007;2007:64250E. https://doi.org/10.1117/12.699475.Hatayama H., Kato J., Inoue A., Akashi G., Hirai Y. Comparison of violet diode laser with CO2-laser in surgical performance of soft tissues. Proc. SPIE. 2007;2007:64250E. https://doi.org/10.1117/12.699475.Strong M.S., Jako G.J. Laser surgery in the larynx. Early clinical experience with continuous CO2-laser. Ann Otol Rhinol Laryngol. 1972;81(6):791–798. https://doi.org/10.1177/000348947208100606.Strong M.S., Jako G.J. Laser surgery in the larynx. Early clinical experience with continuous CO2-laser. Ann Otol Rhinol Laryngol. 1972;81(6):791–798. https://doi.org/10.1177/000348947208100606.Yonekawa H. A clinical study of Reinke’s edema. Auris Nasus Larynx. 1988;15(1):57–78. https://doi.org/10.1016/s0385-8146(88)80010-5.Yonekawa H. A clinical study of Reinke’s edema. Auris Nasus Larynx. 1988;15(1):57–78. https://doi.org/10.1016/s0385-8146(88)80010-5.Tan M., Bryson P.C., Pitts C., Woo P., Benninger M.S. Clinical grading of Reinke’s edema. Laryngoscope. 2017;127(10):2310–2313. https://doi.org/10.1002/lary.26647.Tan M., Bryson P.C., Pitts C., Woo P., Benninger M.S. Clinical grading of Reinke’s edema. Laryngoscope. 2017;127(10):2310–2313. https://doi.org/10.1002/lary.26647.Svistushkin V.M., Rakunova E.B., Starostina S.V. High energy techniques in surgical treatment of reinke’s edema (data analyses and our experience). Meditsinskiy Sovet. 2018;(8):90–93. (In Russ.) https://doi.org/10.21518/2079-701X-2018-8-90-93.Svistushkin V.M., Rakunova E.B., Starostina S.V. High energy techniques in surgical treatment of reinke’s edema (data analyses and our experience). Meditsinskiy Sovet. 2018;(8):90–93. (In Russ.) https://doi.org/10.21518/2079-701X-2018-8-90-93.Kleinsasser O. Mikrolaryngoskopie und endolaryngeale Mikrochirurgie. Technik und Typische Befunde Stuttgart. New York; 1968. 180 p.Kleinsasser O. Mikrolaryngoskopie und endolaryngeale Mikrochirurgie. Technik und Typische Befunde Stuttgart. New York; 1968. 180 p.Vincentiis М., Ralli М., Cialente F., Greco A. Reinke’s edema: a proposal for a classification based on morphological characteristics. Eur Arch Otorhinolaryngol. 2020;277(8):2279–2283. https://doi.org/10.1007/s00405-020-05934-8.Vincentiis М., Ralli М., Cialente F., Greco A. Reinke’s edema: a proposal for a classification based on morphological characteristics. Eur Arch Otorhinolaryngol. 2020;277(8):2279–2283. https://doi.org/10.1007/s00405-020-05934-8.Kryukov A.I., Tsarapkin G.Yu., Arzamasov S.G., Panasov S.A. The application of lasers in otorhinolaryngology. Vestnik Oto-Rino-Laringologii. 2016;81(6):62–66. https://doi.org/10.17116/otorino20168162-66.Kryukov A.I., Tsarapkin G.Yu., Arzamasov S.G., Panasov S.A. The application of lasers in otorhinolaryngology. Vestnik Oto-Rino-Laringologii. 2016;81(6):62–66. https://doi.org/10.17116/otorino20168162-66.Hermens J.M., Bennett M.J., Hirshman C.A. Anesthesia for laser surgery. Anesth Analg. 1983;62(2):218–229. Available at: https://www.ncbi.nlm.nih.gov/pubmed/6338757.Hermens J.M., Bennett M.J., Hirshman C.A. Anesthesia for laser surgery. Anesth Analg. 1983;62(2):218–229. Available at: https://www.ncbi.nlm.nih.gov/pubmed/6338757.Wang Z., Devaiah A.K., Feng L., Dasai U., Shapira G., Weisberg O. et al. Fiber-guided CO2 laser surgery in an animal model. Photomed Laser Surg. 2006;24(5):646–650. https://doi.org/10.1089/pho.2006.24.646.Wang Z., Devaiah A.K., Feng L., Dasai U., Shapira G., Weisberg O. et al. Fiber-guided CO2 laser surgery in an animal model. Photomed Laser Surg. 2006;24(5):646–650. https://doi.org/10.1089/pho.2006.24.646.Crockett D.M., Reynolds B.N. Laryngeal laser surgery. Otolaryngol Clin North Am. 1990;23(1):49–66. Available at: https://www.ncbi.nlm.nih.gov/pubmed/2179824.Crockett D.M., Reynolds B.N. Laryngeal laser surgery. Otolaryngol Clin North Am. 1990;23(1):49–66. Available at: https://www.ncbi.nlm.nih.gov/pubmed/2179824.Eckel H.E., Remacle M. Instrumentation for endolaryngeal surgery. The materials of the 6th European congress of oto-rhino-laryngology, head and neck surgery. Vienna, Austria; 2007, pp. 11.Eckel H.E., Remacle M. Instrumentation for endolaryngeal surgery. The materials of the 6th European congress of oto-rhino-laryngology, head and neck surgery. Vienna, Austria; 2007, pp. 11.Nazhmudinov I.I., Serebryakova I.Yu., Magomedova K.M. Application of modern technologies in the treatment of precancerous diseases of the larynx. Vestnik Oto-Rino-Laringologii. 2018;83(5):45–48. (In Russ.) https://doi.org/10.17116/otorino20188305145.Nazhmudinov I.I., Serebryakova I.Yu., Magomedova K.M. Application of modern technologies in the treatment of precancerous diseases of the larynx. Vestnik Oto-Rino-Laringologii. 2018;83(5):45–48. (In Russ.) https://doi.org/10.17116/otorino20188305145.Abdullaev B.Z., Nazhmudinov I.I., Daikhes N.A. Application of modern technologies in the treatment of Reinke – Gayek disease. Astana Medical Journal. 2016;87(1):193–197. (In Russ.) Available at: https://www.amu.kz/science_and_research_clinic/science/scientific_publications_ao_mua/astanalyk_medicine_journals/%D0%90%D0%9C%D0%96%201_2016.pdf.Abdullaev B.Z., Nazhmudinov I.I., Daikhes N.A. Application of modern technologies in the treatment of Reinke – Gayek disease. Astana Medical Journal. 2016;87(1):193–197. (In Russ.) Available at: https://www.amu.kz/science_and_research_clinic/science/scientific_publications_ao_mua/astanalyk_medicine_journals/%D0%90%D0%9C%D0%96%201_2016.pdf.Abdullaev B.Z., Nazhmudinov I.I., Daikhes N.A. The use of CO 2 laser in the treatment of Reinke – Gayek disease. Bulletin of the Dagestan State Medical Academy. 2016;1(18):62–64. (In Russ.) Available at: http://vestnikdgma.ru/sites/default/files/1_vestnik_1_18_.pdf.Abdullaev B.Z., Nazhmudinov I.I., Daikhes N.A. The use of CO 2 laser in the treatment of Reinke – Gayek disease. Bulletin of the Dagestan State Medical Academy. 2016;1(18):62–64. (In Russ.) Available at: http://vestnikdgma.ru/sites/default/files/1_vestnik_1_18_.pdf.Haug M.H., Møller P., Olofsson J. Laser surgery in otorhinolaryngology: a 10-year experience. J Otolaryngol. 1993;22(1):42–45. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8445703.Haug M.H., Møller P., Olofsson J. Laser surgery in otorhinolaryngology: a 10-year experience. J Otolaryngol. 1993;22(1):42–45. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8445703.Karpishchenko S.A., Ryabova M.A., Ulupov M.Yu., Shumilova N.A., Portnov G.V. The choice of parameters for the laser application in ENT surgery. Vestnik Oto-Rino-Laringologii. 2016;81(4):14–18. (In Russ.) https://doi.org/10.17116/otorino201681414-18.Karpishchenko S.A., Ryabova M.A., Ulupov M.Yu., Shumilova N.A., Portnov G.V. The choice of parameters for the laser application in ENT surgery. Vestnik Oto-Rino-Laringologii. 2016;81(4):14–18. (In Russ.) https://doi.org/10.17116/otorino201681414-18.Rakunova E.B. The modern possibilities for the treatment of the patients presenting with benign and tumour-like diseases of the larynx. Vestnik Oto-Rino-Laringologii. 2017;82(1):68–72. (In Russ.) https://doi.org/10.17116/otorino201681414-18.Rakunova E.B. The modern possibilities for the treatment of the patients presenting with benign and tumour-like diseases of the larynx. Vestnik Oto-Rino-Laringologii. 2017;82(1):68–72. (In Russ.) https://doi.org/10.17116/otorino201681414-18.Yan Y., Olszewski A.E., Hoffman R.M., Ford C.N., Dailey H.S., Jiang S.H. Use of lasers in laryngeal surgery. J Voice. 2010;24(1):102–109. https://doi.org/10.1016/j.jvoice.2008.09.006.Yan Y., Olszewski A.E., Hoffman R.M., Ford C.N., Dailey H.S., Jiang S.H. Use of lasers in laryngeal surgery. J Voice. 2010;24(1):102–109. https://doi.org/10.1016/j.jvoice.2008.09.006.Zeitels S.M., Burns J.A. laser applications in laryngology: past, present, future. Otolaryngol Clin N Am. 2006;39(1):159–172.https://doi.org/10.1016/j.otc.2005.10.001.Zeitels S.M., Burns J.A. laser applications in laryngology: past, present, future. Otolaryngol Clin N Am. 2006;39(1):159–172.https://doi.org/10.1016/j.otc.2005.10.001.Hörmann K., Baker-Schreyer A., Keilmann A., Biermann G. Functional results after CO2 laser surgery compared with conventional phonosurgery. J Laryngol Otol. 1999;113(2):140–144. https://doi.org/10.1017/s0022215100143397.Hörmann K., Baker-Schreyer A., Keilmann A., Biermann G. Functional results after CO2 laser surgery compared with conventional phonosurgery. J Laryngol Otol. 1999;113(2):140–144. https://doi.org/10.1017/s0022215100143397.Geyer M., Ledda G., Tan N., Brennan P., Puxeddu R. Carbon dioxide laser-assisted phonosurgery for benign glottic lesions. Eur Arch Otorhinolaryngol. 2009;267(1):87–93. https://doi.org/10.1007/s00405-009-1031-7.Geyer M., Ledda G., Tan N., Brennan P., Puxeddu R. Carbon dioxide laser-assisted phonosurgery for benign glottic lesions. Eur Arch Otorhinolaryngol. 2009;267(1):87–93. https://doi.org/10.1007/s00405-009-1031-7.Hantzakos A., Remacle M., Dikkers F.G., Degols H., Delos M., Friedrich G. et al. Exudative lesions of Reinke’s space: a terminology proposal. Eur Arch Otorhinolaryngol. 2008;266(6):869–878. https://doi.org/10.1007/s00405-008-0863-x.Hantzakos A., Remacle M., Dikkers F.G., Degols H., Delos M., Friedrich G. et al. Exudative lesions of Reinke’s space: a terminology proposal. Eur Arch Otorhinolaryngol. 2008;266(6):869–878. https://doi.org/10.1007/s00405-008-0863-x.Dejonckere P., Bradley P., Clemente P., Cornut G., Crevier-Buchman L., Friedrich G. et al. A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Eur Arch Otorhinolaryngol. 2001;258(2):77–82. https://doi.org/10.1007/s004050000299.Dejonckere P., Bradley P., Clemente P., Cornut G., Crevier-Buchman L., Friedrich G. et al. A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Eur Arch Otorhinolaryngol. 2001;258(2):77–82. https://doi.org/10.1007/s004050000299.Martins R., Santana M., Tavares E. Vocal Cysts: Clinical, Endoscopic, and Surgical Aspects. J Voice. 2011;25(1):107–110. https://doi.org/10.1016/j.jvoice.2009.06.008.Martins R., Santana M., Tavares E. Vocal Cysts: Clinical, Endoscopic, and Surgical Aspects. J Voice. 2011;25(1):107–110. https://doi.org/10.1016/j.jvoice.2009.06.008.Ware J.E., Snow K.K., Kosinski M., Gandek B. SF-36 Health Survey: Manual and interpretation guide. Boston, Mass.: Health institute, New Engl Med Center; 1993. Available at: https://www.researchgate.net/publication/247503121_SF36_Health_Survey_Manual_and_Interpretation_Guide.Ware J.E., Snow K.K., Kosinski M., Gandek B. SF-36 Health Survey: Manual and interpretation guide. Boston, Mass.: Health institute, New Engl Med Center; 1993. Available at: https://www.researchgate.net/publication/247503121_SF36_Health_Survey_Manual_and_Interpretation_Guide.

The authors declare that there are no conflicts of interest present.