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外周神经源性声带麻痹的保守手术指征及时机(作者译)

[Indication and timing of conservative surgery of peripheral neurogenic vocal cord pareses (author's transl)].

作者信息

Gabriel P, Chilla R

出版信息

HNO. 1975 Nov;23(11):333-6.

PMID:1081985
Abstract
  1. In every case of a vocal cord paresis, its cause should be carefully sought. 2. "Pseudopareses" of the vocal cord can be excluded by electromygraphy. 3. In all cases of neurogneic vocal cord praeses and regardless of aetiology, immediate phoniatric training is indicated for acceleration of nerve regeneration as well as electrostimulation for the prevention of muscular atrophy and ankylosis of the cricoarytenoid joint. 4. If such therapy is neglected, the functional results of spontaneous regeneration, neurolysis and nerve plasty are doubtful. 5. If in cases of mechanical lesions of the recurrent nerve one decides to operate, electromyography of the larynx and a mobility test of the cricoarytenoid joints to be done first. 6. Compression or overstretching of the nerve should be followed by neurolysis after 5 months, unless the nerve has regenerated spontaneously. 7. When the recurrent nerve has had to be served it should be repaired by anastomosis as soon as possible. 8. Judging by our experience in regeneration of the laryngeal nerves, we feel that operations for opening or closure of the glottis are indicated only after 2 years.
摘要
  1. 在每一例声带麻痹病例中,都应仔细寻找其病因。2. 声带“假性麻痹”可通过肌电图排除。3. 在所有神经性声带麻痹病例中,无论病因如何,均应立即进行发声训练以加速神经再生,并进行电刺激以预防环杓关节肌肉萎缩和关节强直。4. 如果忽视这种治疗,自发再生、神经松解术和神经成形术的功能结果将难以确定。5. 如果在喉返神经机械性损伤的病例中决定进行手术,应首先进行喉部肌电图检查和环杓关节活动度测试。6. 除非神经已自发再生,否则在神经受压或过度拉伸5个月后应进行神经松解术。7. 当喉返神经必须进行修复时,应尽快通过吻合术进行修复。8. 根据我们在喉神经再生方面的经验,我们认为仅在2年后才适合进行声门开放或闭合手术。

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