Hong K H, Jung K S
Department of Otolaryngology--Head and Neck Surgery, Medical School, Institute for Medical Science, Chonbuk National University, Chonju, Korea.
Laryngoscope. 2001 Feb;111(2):227-32. doi: 10.1097/00005537-200102000-00007.
OBJECTIVES/HYPOTHESIS: In unilateral vocal fold paralysis, it has been generally accepted that the paralyzed vocal fold presents at a higher level than a normally innervated vocal fold. In this study, we correlate the appearances of the paralyzed arytenoid and the differences in level between the paralyzed and innervated vocal folds.
Retrospective review using video-recorded images of larynx.
A total of 38 patients were selected for this study who reported symptoms of voice change attributable to a paralyzed vocal fold unilaterally. Video recordings were obtained using the laryngeal telescope. The heights were assessed according to the paralyzed positions, status (inspiration or phonation), and appearances of the paralyzed arytenoid. The appearances of paralyzed arytenoid were further clarified as the portions of the medial surface of the arytenoid that were visualized.
In medial paralysis, the paralyzed vocal fold appeared mainly as being at an equal vertical level or as having no distinct difference from normal vocal fold during phonation. However, a few cases of medial paralysis showed a lower than normal or higher than normal vocal fold during phonation, depending on the appearance of the paralyzed arytenoid. In lateral paralysis, most of the paralyzed vocal folds were not higher than the innervated vocal folds during phonation.
The heights of paralyzed vocal folds were variable depending on the paralyzed positions, the status of the larynx, and appearances of the paralyzed arytenoid. The fact that the paralyzed vocal fold is at a higher level than the normal vocal fold should be reconsidered.
目的/假设：在单侧声带麻痹中，一般认为麻痹的声带比正常受神经支配的声带位置更高。在本研究中，我们将麻痹的杓状软骨外观与麻痹和受神经支配的声带之间的高度差异进行关联。
使用喉部视频记录图像进行回顾性研究。
本研究共选取38例因单侧声带麻痹出现声音改变症状的患者。使用喉镜获取视频记录。根据麻痹位置、状态（吸气或发声）以及麻痹杓状软骨的外观评估高度。麻痹杓状软骨的外观进一步明确为杓状软骨内侧面可视化的部分。
在内侧麻痹中，麻痹的声带在发声时主要表现为与正常声带处于同一垂直水平或无明显差异。然而，少数内侧麻痹病例在发声时声带低于或高于正常，这取决于麻痹杓状软骨的外观。在外侧麻痹中，大多数麻痹的声带在发声时不高于受神经支配的声带。
麻痹声带的高度因麻痹位置、喉部状态以及麻痹杓状软骨的外观而异。麻痹声带比正常声带位置更高这一事实应重新考虑。
