显微支撑喉镜下手术治疗沟状声带  

Mucosal Microflap Technique with Suspension Microlaryngoscopy Surgery for Sulcus Vocalis

作　　者：秦贺[1] 黄金中[1] 程友[1] 唐乔[1] 龚剑[1] 

机构地区：[1]南方医科大学珠江医院耳鼻咽喉-头颈外科,广州510282

出　　处：《听力学及言语疾病杂志》2007年第6期451-453,I0002,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨显微支撑喉镜下应用黏膜微瓣技术治疗沟状声带的疗效。方法对31例Ⅱ型或Ⅲ型沟状声带患者在显微支撑喉镜下切除声带沟底病变,采用黏膜微瓣技术缝合修复创面。手术前、后,应用动态喉镜观察声带形态、声门闭合情况及黏膜波变化特点,应用Dr.Speech4.0软件进行嗓音客观参数声学分析。结果所有病例均一次手术成功,无术后并发症。31例患者术后1个月发声改善明显,术后6个月音质稳定,嗓音声学参数与术前比较差异有统计学意义(P<0.01)。动态喉镜检查声带形态接近正常,声门闭合改善,黏膜波接近正常。随访1～3年,音质稳定。结论显微支撑喉镜下黏膜微瓣技术治疗沟状声带有利于声带黏膜创面愈合,减少疤痕形成,利于发声功能恢复。Objective To investigate the effectiveness of mucosal microflap technique with suspension microlaryngoscopy surgery in patients with sulcus vocalis,so as to find a way of reserving normal high quality phonatory function after sulcus vocalis surgery. Methods Under general anesthesia,thirty-one patients with sulcus vocalis of typeⅡ or Ⅲ underwent mucosal microflap technique in suspension microlaryngoscopic exposure,including excising the sulcus and reshaping the vocal fold with mucosal microflap. Acoustic, phonatory function and videolaryngostroboscopic data were evaluated before and after operation. Results No postoperative complications were noted. Vocal quality became better 1 month after operation and maintained steady after the surgery. Acoustic, phonatory function improved significantly in terms of jitter, shimmer, NNE and MPT（P〈0.01 ）. The videolaryngostroboscopic rating showed significant improvement in shapes,glottal closures, vocal fold vibration amplitude and excursion of the mucosal wave. Conclusion Mucosal microflap technique with suspension microlaryngoscopy surgery is able to treat sulcus vocalis with fast recovering effects and least complications. It has noticeable clinical values.

关 键 词：沟状声带 黏膜微瓣技术 嗓音显微手术 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]