环杓关节脱位的诊疗研究进展  

Research progress on diagnosis and treatment of arytenoid dislocation

作　　者：朱振文 鲁媛媛 于振坤 Zhu Zhenwen;Lu Yuanyuan;Yu Zhenkun(Department of Otorhinolaryngology-Head and Neck Surgery,the Affiliated BenQ Hospital of Nanjing Medical University,Nanjing 210019,China)

机构地区：[1]南京医科大学附属明基医院耳鼻咽喉头颈外科,南京210019

出　　处：《中华解剖与临床杂志》2022年第10期731-736,共6页Chinese Journal of Anatomy and Clinics

摘　　要：目的总结环杓关节脱位诊断与治疗方法的研究进展。方法在SinoMed、万方数据库以及PubMed等中英文数据库中检索2022年之前发表的环杓关节脱位诊断与治疗的相关文献共3241篇,剔除重复检索、内容相关性低、无法获得全文、质量较低以及创新性差的文献,对最终纳入的46篇文献进行归纳总结和分析。结果环杓关节脱位一旦发生,对患者生活质量将造成很大影响;其检查方法有病史询问、电子(频闪)喉镜、CT、喉肌电图和嗓音分析等,确诊往往需要结合多种检查手段。根据病情需要、患者意愿、医院条件,环杓关节脱位的治疗有局部麻醉下闭合复位、全身麻醉下闭合复位、脂肪注射、开放复位及嗓音矫治等方法可供选择。结论环杓关节脱位的辅助检查方法各有利弊,对脱位的侧别、程度、方位精准诊断需多种检查手段相结合。复位需要在合适的时间窗进行,全身麻醉、可视喉镜下、复位钳夹持杓状软骨的闭合复位方法,可减轻患者痛苦,便于术者操作,是重要的治疗措施;嗓音矫治是其有效的辅助治疗手段。Objective A study was conducted to summarize the latest progress on the diagnosis and treatment of arytenoid dislocation(AD).Methods A total of 3241 articles on the diagnosis and treatment of AD that were published before 2022 were searched in databases,such as SinoMed,Wanfang,and PubMed.The literatures that had repeated search,low content relevance,unavailable full text,low quality,and poor innovation were excluded.Forty-six literatures were finally included,and these were summarized and analyzed.Results AD can seriously affect patients'quality of life.Medical history,electronic(stroboscopic)laryngoscope,CT,laryngeal electromyography,and voice analysis are available diagnostic methods that should be combined.According to the patient's condition and needs,as well as the competence of the hospital,the patient can choose from various treatments,such as closed reduction under local anesthesia,closed reduction under general anesthesia,fat injection,open reduction,and voice therapy.Conclusion Every approach used to diagnose cricoarytenoid joint dislocation has its own advantages and disadvantages.The precise diagnosis of the affected side,extent of dislocation,and orientation requires the combination of multiple methods.An appropriate time window is needed when treating patients.The closed reduction of arytenoid cartilage under general anesthesia with visual laryngoscope and reduction forceps can reduce pain,allowing the surgeon to operate more calmly;this can also facilitate recording and sharing,which is an important treatment measure.Moreover,voice therapy is an effective adjuvant treatment.

关 键 词：脱位 环杓关节 关节复位 嗓音 喉镜 

分 类 号：R684.7[医药卫生—骨科学]