Baujat B, Delbove H, Wagner I, Fugain C, de Corbière S, Chabolle F
Service ORL et chirurgie de la face et du cou, hôpital Foch, 40, rue Worth, 92151 Suresnes, France.
Ann Chir. 2001 Mar;126(2):104-10. doi: 10.1016/s0003-3944(00)00488-0.
One of the most common complications of surgery of the thyroid gland is vocal folds immobility. New advances in its management have been achieved over the last few years. Laryngeal electromyography, stroboscopy, and computerized analysis of the voice help guide diagnosis, allowing differentiation between recurrent nerve paralysis and glottis traumatism due to intubation, and further follow-up of recovery with relevant therapeutic decisions. In case of unilateral vocal fold paralysis, intrafold silicone or injection of autologous fat is more and more routinely used to obtain vocal rehabilitation. In case of bilateral vocal fold paralysis, to avoid tracheotomy, partial posterior cordectomy using laser surgery restores sufficient laryngeal airflow, with minimal vocal sequelae. Early management of these complications by teams of specialists should allow appropriate and less invasive surgery.
甲状腺手术最常见的并发症之一是声带运动障碍。在过去几年中，其治疗方面取得了新进展。喉肌电图、频闪喉镜检查以及嗓音的计算机分析有助于指导诊断，能够区分喉返神经麻痹和插管导致的声门创伤，并进一步对恢复情况进行随访以及做出相关治疗决策。对于单侧声带麻痹的情况，声带内注射硅胶或自体脂肪越来越常规地用于实现嗓音康复。对于双侧声带麻痹的情况，为避免气管切开术，使用激光手术进行部分后索切除术可恢复足够的喉部气流，且嗓音后遗症最小。由专家团队对这些并发症进行早期处理应能实现更合适且侵入性更小的手术。
