Isshiki N, Haji T, Yamamoto Y, Mahieu H F
Isshiki Clinic for Plastic Surgery and Otolaryngology, Kyoto, Japan.
Laryngoscope. 2001 Apr;111(4 Pt 1):615-21. doi: 10.1097/00005537-200104000-00011.
Two different surgical techniques for midline lateralization thyroplasty (type 2 thyroplasty) for adductor spasmodic dysphonia (SD) have been described, one using a composite graft and the other without. Indications and results for each method among different types of SD were compared, together with the theoretical background for the surgery.
Retrospective.
The medical records of six patients with SD together with the fiberscopic video recording of laryngeal findings before, during, and after surgery were reviewed. The intraoperative video recordings of the surgical procedures were compared with the postoperative findings.
The vocal features of SD, diverse preoperatively, disappeared postoperatively and a normal, or almost normal, voice was attained in 5 of 6 cases. The failure in one patient was attributed to combined focal dystonia of the neck muscles and difficulty in lateralization. Type 2 thyroplasty without a graft, which causes bowing of both vocal folds, is simple to perform and effective enough for most SD cases. No recurrence has been noted so far over postoperative periods ranging from 6 months to more than 3 years.
The results suggest that thyroplasty is an effective therapeutic approach for SD.
已描述了两种用于内收型痉挛性发声障碍（SD）的中线旁化喉成形术（2型喉成形术）的不同手术技术，一种使用复合移植物，另一种不使用。比较了不同类型SD中每种方法的适应症和结果，以及手术的理论背景。
回顾性研究。
回顾了6例SD患者的病历以及手术前、手术期间和手术后喉部检查结果的纤维喉镜视频记录。将手术过程的术中视频记录与术后结果进行比较。
SD的发声特征术前各不相同，术后消失，6例中有5例获得了正常或几乎正常的嗓音。1例患者手术失败归因于颈部肌肉合并局灶性肌张力障碍和旁化困难。不使用移植物的2型喉成形术会导致双侧声带弓状，操作简单，对大多数SD病例足够有效。术后6个月至3年多的随访期间，尚未发现复发情况。
结果表明，喉成形术是治疗SD的有效方法。
