单侧特发性声带麻痹神经电刺激治疗后即刻疗效初步观察  

Preliminary observation of the immediate curative effect of unilateral idiopathic vocal cord palsy after electrical stimulation of the nerve

作　　者：闫静[1] 任晓勇[1] 向莉[2] 杜小滢[1] 李娜[1] 刘小红[1] 侯瑾[1] YAN Jing;REN Xiaoyong;XIANG Li;DU Xiaoying;LI Na;LIU Xiaohong;HOU Jin(Department of Otorhinolaryngology&Head and Neck Surgery,Second Affiliated Hospital of Medical College,Xi̓'an JiaotongU niversity,Xi̓'an 710004,Shanxi China;Department of Neurology,Second Affiliated Hospital of Medical College,Xi̓'an Jiaotong University,Xi̓'an 710004,Shanxi China)

机构地区：[1]西安交通大学第二附属医院耳鼻咽喉头颈外科病院,陕西西安710004 [2]西安交通大学第二附属医院神经内科,陕西西安710004

出　　处：《山东大学耳鼻喉眼学报》2021年第3期42-46,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：陕西省重点研发计划(一般项目-社会发展领域)S2020⁃YF⁃YBSF⁃0207。

摘　　要：目的探讨单侧特发性声带麻痹喉返神经/喉上神经电刺激治疗后即刻对主观声音改变、声学参数以及动态喉镜观察结果的影响。方法选取诊断为单侧特发性声带麻痹的患者,回顾性收集其行喉肌电图检查并同期行神经电刺激治疗前后的动态喉镜及嗓音分析检查结果,分析检查及治疗前后主观声音改变,声学参数(jitter、shimmer、DSI、MPT)及动态喉镜观察结果。结果共计43例单侧特发性声带麻痹患者符合纳入标准,其中喉返神经合并喉上神经受损4例、喉上神经受损1例、喉返神经受损38例。喉肌电图检查及神经电刺激治疗后患者即刻均自觉讲话较前轻松感;治疗后即刻动态喉镜检查发现5例(11.6%)患者声带闭合较前无明显变化,声嘶无明显好转;38例(88.4%)患者动态喉镜显示声门裂均较检查前明显变小,可采集到基频及黏膜波,声嘶较前明显好转;声学参数前后变化:MPT(6.58±2.75 vs 10.3±5.18,P<0.001)、DSI(-3.79±6.7 vs-0.11±1.68,P=0.002),jitter及shimmer治疗前后比较差异无统计学意义(P>0.05)。结论特发性声带麻痹患者早期接受喉肌电图检查及神经电刺激干预治疗可改善患者声嘶,明显延长最长发音时间,改善嗓音障碍严重指数,显著改善声门闭合程度,提示对神经功能的恢复有促进作用。Objective To explore the effects of idiopathic vocal cord paralysis on subjective sound changes,acoustic parameters,and dynamic laryngoscope observations immediately after electrical stimulation of the recurrent laryngeal nerve/supralaryngeal nerve.Methods The records of patients who were diagnosed with unilateral idiopathic vocal cord paralysis at the Throat Clinic of the Second Affiliated Hospital of Xi?an Jiaotong University from March 2018 to April 2020 before and after undergoing laryngeal EMG examination and concurrent neuroelectric stimulation treatment were reviewed.The stroboscopic laryngoscopy and voice analysis results,subjective voice changes before and after examination and treatment,acoustic parameters(jitter,shimmer,MPT),and dynamic laryngoscope observation results were assessed.Results A total of 43 patients with unilateral idiopathic vocal cord paralysis met the inclusion criteria:4 had recurrent laryngeal nerve damage of the superior laryngeal nerve,1 had superior laryngeal nerve damage,and 38 had recurrent laryngeal nerve damage.After laryngeal electromyography and nerve electrical stimulation treatment,the patients felt that their speech was more relaxed than before.Stroboscopic laryngoscopy immediately after treatment revealed that 5 patients(11.6%)had closed vocal cords.There was no significant change.In 38 cases(88.4%),the glottis was significantly smaller after than before the examination,and the fundamental frequency and mucosal waves could be collected.The changes in acoustic parameters did not significantly differ after treatment:MPT(6.58±2.75 vs 10.3±5.18,P<0.0001),DSI(-3.79±6.7vs-0.11±1.68,P=0.002),jitter and shimmer(P>0.05).Conclusion Patients with idiopathic vocal cord palsy receiving early laryngeal electromyography and nerve electrical stimulation intervention can improve hoarseness,significantly extend the longest pronunciation time,improve the severity index of voice disorders,and significantly improve the degree of glottis closure.The recovery of the nerve function has a po

关 键 词：特发性声带麻痹 喉肌电图 电刺激治疗 声学参数 喉上神经 喉返神经 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]