杓状软骨部分切除联合声带后份裂开术治疗双侧声带麻痹的临床疗效研究  

Study on the efficacy of posterior cordotomy with partial arytenoidectomy in bilateral vocal fold paralysis

作　　者：莫微 宋柳 于凌昱 景星滔 杨慧[1] MO Wei;SONG Liu;YU Lingyu;JING Xingtao;YANG Hui(Department of Otorhinolaryngology Head Neck Surgery,West China Hospital,Sichuan University,Chengdu,610041,China)

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科,成都610041

出　　处：《临床耳鼻咽喉头颈外科杂志》2024年第10期912-916,922,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨杓状软骨部分切除联合声带后份裂开术在双侧声带麻痹(BVFP)中的临床疗效。方法:收集四川大学华西医院耳鼻咽喉-头颈外科2019年1月-2023年12月收治入院且资料完整并完成随访的BVFP患者共37例,对其术前和术后呼吸功能、嗓音质量和吞咽功能等进行评估。结果:37例患者中,32例(86.5%)患者呼吸困难明显缓解,29例气切患者中26例术后成功拔管,拔管率为89.7%,术后1个月复查,33例(89.2%)患者嗓音质量较术前下降,5例(13.5%)吞咽功能下降,但术后3个月嗓音及吞咽明显改善。结论:杓状软骨部分切除联合声带后份裂开是一种治疗BVFP有效的手术方法,成功率高,对嗓音质量影响有限,对吞咽功能无明显影响,具有较高的临床应用价值。Objective The aim of this study is to investigate the efficacy of posterior cordotomy with partial arytenoidectomy in bilateral vocal fold paralysis(BVFP).Methods Medical records of 37 patients with BVFP were retrospectively collected,and they were all admitted to the Department of Otolaryngology-Head and Neck Surgery,West China Hospital of Sichuan University,from Jan.2019 to Dec.2023.Preoperative and postoperative evaluations of respiratory function,voice quality,and swallowing function were conducted.Results Postoperatively,32 out of 37 patients achieved significant relief in breathing difficulties.Out of 29 patients with tracheostomy,26(89.7%)were successfully decannulated.One month postoperative follow-up revealed a decline in voice quality for 33 patients(89.2%),and 5 cases(13.5%)reported a decrease in swallowing function.However,by three months postoperatively,both voice quality and swallowing function showed significant improvement.Conclusion Posterior cordotomy with partial arytenoidectomy is an effective surgical method for BVFP,and significantly improve respiratory difficulty despite its impact on voice quality,with no significant impairment to swallowing function,shows significant clinical value.

关 键 词：双侧声带麻痹 杓状软骨切除 内镜微创外科手术 

分 类 号：R767.9[医药卫生—耳鼻咽喉科]