声带良性病变伴隐匿性声带沟的临床治疗分析  

Clinical treatment of benign vocal cord lesions with occult vocal cord sulcus

作　　者：肖洋[1] 王甜甜 马丽晶[1] 郭伟[1] 王军[1] XIAO Yang;WANG Tiantian;MA Lijing;GUO Wei;WANG Jun(Key Laboratory of Otolaryngology Head and Neck Surgery（Ministry of Education of China）,Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Department of Otolaryngology Head and Neck Surgery,the Third Hospital of Shandong Provincial)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730 [2]山东省立第三医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第17期1335-1338,1342,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：首都医科大学附属北京同仁医院院内基金(No:2016-YJJ-GGL-022)

摘　　要：目的:对声带良性病变并发隐匿性声带沟患者的手术资料、术前嗓音评估资料和术后随访资料进行分析,探讨声带良性病变与隐匿性声带沟的临床相关性与治疗方法。方法:对2005-2016年通过手术治疗的377例声带良性病变术中发现声带沟患者的病例资料进行整理和分析,术后随访半年以上。结果:约2.9%的声带良性病变合并隐匿性声带沟,其中61.27%为双侧声带沟,22.55%为右侧声带沟,16.18%为左侧声带沟。双侧声带沟患者中64.5%伴双声带良性病变,35.5%伴单侧声带良性病变。单侧声带沟患者中73.97%伴同侧声带良性病变,26.03%伴对侧声带病变。531侧声带沟中,183侧Ⅰ型声带沟未予处理;332侧Ⅱ型声带沟去除声带病变的同时显微剥离松解声带沟底粘连;16侧Ⅲ型声带沟去除病变、松解粘连后局部填塞自体腹部筋膜并显微缝合创面;其中声带沟伴黏膜桥共9例(11侧)。术后半年时声音改善满意率为80.37%,术后基频、基频微扰、振幅微扰和最大发声时间较术前均明显好转。结论:声带良性病变的发生可能与声带沟有关,同期处理声带病变和病理性声带沟可以获得较满意的嗓音改善,因此在声带良性病变的诊疗过程中要注意对声带沟的处理。Objective：To discuss the correlation of benign vocal cord lesions with occult vocal cord sulcus and the treatment of benign vocal cord lesions with occult vocal cord sulcus,through the analysis of surgical data,preoperative voice evaluation data and postoperative follow-up data of patients.Method：The data from 377 patients of benign vocal cord lesions with concealed vocal cord sulcus admitted to Beijing Tongren Hospital from 2005 to 2016 were reviewed.The follow-up time was more than half a year after surgery.Result：About 2.9% of the benign lesions of the vocal cords were associated with occult vocal cords sulcus,of which 61.27% were bilateral vocal cords sulcus,22.55% was right vocal cords sulcus,and 16.18% was left vocal cord sulcus.Of the patients with bilateral vocal fold sulcus,64.5% had benign vocal cord lesions and 35.5% had unilateral vocal cord benign lesions.Of the patients with unilateral vocal fold,73.97%were associated with ipsilateral vocal cord benign lesions,and 26.03% were associated with contralateral vocal cord lesions.In the 531 sides of the vocal cords sulcus,183 sides of vocal fold sulcus typeⅠwere not treated.The 332 sides of vocal fold sulcus typeⅡwere treated with removed lesions of the vocal cords and microdissection of vocal cord adhesion.The 16 sides of vocal fold sulcus typeⅢ were treated with removed lesions of the vocal cords,local tamponaded of autogenous abdominal fascia and microsutured to close the wound.There were 9 cases with 11 sides of vocal fold sulcus combined with the mucous bridge.The satisfactory rate of sound improvement was 80.37%in half a year after the operation.Postoperative fundamental frequency,jitter,shimmer and maximum phonation time were significantly improved compared with preoperative.Conclusion：The occurrence of benign vocal cord lesions may be related to occult vocal fold sulcus.Simultaneous treatment of benign vocal cord lesions with occult vocal cord sulcus can achieve satisfactory voice improvement.Therefore,we should pay attention to the

关 键 词：声带沟 声带息肉 声带白斑 嗓音评估 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]