鼻内镜下联合自制角度喉钳切除声门暴露困难声带息肉23例  

Vocal polyps treated with nasal endoscopy and angled-laryngeal forceps: report of 23 cases

作　　者：鞠丽娴 李井成[2] 夏克玉 董伟达[1] JU Lixian;LI Jingcheng;XIA Keyu;DONG Weida(Department of Otorhinolaryngology,The First Affiliated Hospital,Nanjing Medical University;Department of Otorhinolaryngology,Huaiyin Hospital,Huai'an 223300,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院耳鼻咽喉科,江苏南京210029 [2]淮安市淮阴医院耳鼻咽喉科,江苏淮安223300

出　　处：《山东大学耳鼻喉眼学报》2019年第3期116-118,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨鼻内镜下联合自制角度喉钳切除声门暴露困难声带息肉的效果。方法对23例声带息肉手术中遇到声门暴露困难患者,支撑喉镜常规插管后鼻内镜下在成像系统看清病变部位,取合适的喉钳,将喉钳头端1~2cm处制成所需的弯度,将处置过喉钳伸入喉镜至声带息肉处常规咬除息肉,修齐声带边缘。术后常规静脉滴注抗生素3d,并雾化吸入布地奈德气雾剂,2次/d,连续3 d。嘱声休2周,多做深吸气动作,禁烟酒。结果 23例患者均一次完全切除声带息肉,手术时间平均10min,均无颈椎损伤、舌体损伤、牙齿脱落等严重并发症发生。23例术后均获随访3~12个月,平均6个月,患者对术后声音恢复情况满意,无明显的声音嘶哑,复查喉镜检查见声带边缘光滑,无黏连、缺损,随访期间无息肉复发。结论鼻内镜下联合自制角度喉钳切除声门暴露困难的声带息肉疗效确切。Objective To investigate the outcomes of endoscopic removal of vocal cord polyps with angled-laryngeal forceps.Methods Nasal endoscopy was performed after conventional intubation with a support laryngoscope,to identify lesions on an imaging system in23 patients with difficulty in glottis exposure during vocal cord polyp surgery. Appropriate laryngeal forceps were chosen and bent to the required degree,1-2 cm from the end. They were were then extended into the laryngoscope until reaching the vocal cord polyps. The polyps were then routinely excised,and the edge of the acoustic band was subsequently repaired. Postoperative management included routine intravenous infusion of antibiotics for3 days and inhalation of budesonide aerosol twice daily for3 days. The patients were advised2 weeks of rest,deep breathing,and abstinence from smoking and alcohol. Results In all23 patients,the vocal polyps were excised in the first attempt,with an average operative time of10 min,and no serious complications,such as cervical spine injury,tongue injury,or tooth loss. All23 patients were followed up for3-12 months(average,6 months)postoperatively. The postoperative course was uneventful and there was no obvious voice hoarseness. Re-examination using a laryngoscope showed smooth edges of the vocal cords,without adhesion and defects,and no polyp recurrence during the follow-up period. Conclusion Treatment of vocal polyps with difficult exposure of the glottis is possible with nasal endoscopy and angled-laryngeal forceps.

关 键 词：声带息肉 鼻内镜 支撑喉镜 喉钳 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]