干旱区生态环境知识资源中心(Arid): 双侧声带麻痹不同术式治疗前后声门测量及嗓音评价

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	双侧声带麻痹不同术式治疗前后声门测量及嗓音评价
其他题名	Glottic measurement and vocal evaluation after three surgical techniques in the treatment of bilateral vocal cord paralysis
	黄益灯 1; 郑宏良 2; 周水淼 2; 陈建福 3; 李兆基 2; 夏斯文 1; 黄子喜 1; 罗春娟 1
ISSN	1673-0860
出版年	2006
卷号	41 期号:9 页码:648-652
中文摘要	目的探讨3种不同的双侧声带麻痹治疗术后声门面积及嗓音质量.方法 46例双侧声带麻痹患者分别采用激光杓状软骨切除术(A组24例),膈神经替代喉返神经吻合术(B组9例),喉外径路杓状软骨切除声带外移固定术(C组13例)治疗,手术前后行声门测量及嗓音分析.结果 A、B、C组拔管率分别为91.7%(22/24)、88.9%(8/9)、100.0%(13/13),3种术式术后最大开放声门面积平均(-xs)分别为:(47.27.4)mm2、(78.316.0)mm2、(48.16.5)mm2.B组术后声门面积明显大于A、C组,差异有统计学意义(t值分别为4.46和3.85,P值分别为0.000和0.001).A、C组术后声门面积差异无统计学意义(t=1.68,P=0.101).A组术后17例能保持术前的嗓音质量,7例恶化;B组术后5例嗓音好转,1例恢复正常,3例无变化;C组术后3例嗓音无变化,10例恶化.B组9例术后膈神经修复侧膈肌均麻痹不动,肺活量及最大呼吸容量为术前的72%～84%及76%～84%;半年后膈肌动度恢复达35%～76%,肺活量及最大呼吸容量为术前的93%～97%及91%～98%.结论膈神经替代吻合术后拔管患者声门面积最大,嗓音最好.激光杓状软骨切除和喉外径路杓状软骨切除声带外移固定术均能建立足够气道,拔除气管套管,但前者嗓音明显优于后者.
英文摘要	Objective To evaluate postoperative glottic area and vocal quality of three various surgical techniques for treating bilateral vocal cord paralysis, including laser arytenoidectomy (Group A, 24 cases) , reinnervation of the posterior cricoarytenoid muscle by phrenic nerve ( Group B,9 cases) and arytenoidectomy accompanying lateral cordopexy by extralaryngeal approach ( Woodman’s procedure, Group C, 13 oases). Methods 46 eases suffered from bilateral recurrent laryngeal nerve injury were included in our study. The pre-postoperative glotic measurement and vocal acoustic parameters were analyzed. Results The decannulated cases in group A and group B and group C were 22,8,13 respectively. The post-operetive mean maximal glottic area was (47. 2 7. 4) mm2, (78. 3 16. 0) mm2, (48. 1 6.5) mm2 respectively. Group B cases glottic area was larger than that of group A and group C (t value were 4. 46 and 3. 85 ,P value were 0. 000 and 0. 001). No significant difference was found between goup A and goup C (t = 1. 68, P = 0. 101). After surgery, in group A, 17 cases voice quality was the same compared with that of before surgery, and 7 cases voice quality had become worse; In group B, the voice quality had become better in 5 cases, completely recovered in 1 case, and had not change in 3 cases; In group C, the voice quality had become deteriorated in 10 cases and no change in 3 cases. And in group B, ipsilateral diaphragm paralysis in 9 cases after surgery, whose vital capacity and forced vital capacity had decreased to 72%-84% , 76%-84% of that before the surgery respectively; and the diaphragm mobility had recovered by 35%-76% respectively, while vital capacity and forced vital capacity had become 93%-97% , 91%-98% of that before the surgery. In Ggroup B, all cases’ pulmonary function was normal half a year postoperatively. Conclusions Reinnervation of the posterior cricoarytenoid muscle by phrenic nerve seems to be best procedure with better post-operative voice and larger glottic area. Although the sufficient airway for decannulation can be acquired in Croup A and (iroup C, but most of patients in Group A had pre-opfirative vocal level and badly abnormal in Group C.
中文关键词	声带麻痹 ; 声门 ; 语音质量 ; 外科手术
英文关键词	Vocal cord paralysis Glottis Voice qiality Surgery procedures, operative
语种	中文
国家	中国
收录类别	CSCD
WOS类目	OTORHINOLARYNGOLOGY
WOS研究方向	Otorhinolaryngology
CSCD记录号	CSCD:2433737
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/220542
作者单位	1.解放军第118医院耳鼻咽喉科, 温州, 浙江 325000, 中国; 2.第二军医大学长海医院耳鼻咽喉科; 3.温州医学院附属第一医院耳鼻咽喉科
推荐引用方式 GB/T 7714	黄益灯,郑宏良,周水淼,等. 双侧声带麻痹不同术式治疗前后声门测量及嗓音评价[J],2006,41(9):648-652.
APA	黄益灯.,郑宏良.,周水淼.,陈建福.,李兆基.,...&罗春娟.(2006).双侧声带麻痹不同术式治疗前后声门测量及嗓音评价.,41(9),648-652.
MLA	黄益灯,et al."双侧声带麻痹不同术式治疗前后声门测量及嗓音评价".41.9(2006):648-652.