Griffiths L G, Sullivan M, Reid S W
Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, University of Glasgow, Glasgow, Scotland.
Vet Surg. 2001 Jul-Aug;30(4):359-65. doi: 10.1111/j.1532-950x.2001.00359.x.
To compare the clinical effects of unilateral thyroarytenoid lateralization versus unilateral cricoarytenoid laryngoplasty for the treatment of canine laryngeal paralysis. Study Design-A prospective, clinical trial.
Twenty client-owned dogs admitted to Glasgow University Veterinary Hospital (GUVH) between 1997 and 1999 with a diagnosis of laryngeal paralysis.
A thorough evaluation of each dog was undertaken that included history, physical and neurologic examinations, complete blood count, serum biochemistry profile, serum thyroxine (T4) level, and thyroid-stimulating hormone (TSH) assay. The exercise tolerance of each dog was investigated by assessing respiratory rate and arterial blood gas analysis at rest and after 5 minutes of mild exercise. Animals were included in the study on the basis of a definitive diagnosis of laryngeal paralysis made by endoscopic observation of the larynx in the lightly anesthetized patient. The animals were randomly assigned to 1 of 2 treatment groups: unilateral thyroarytenoid lateralization or unilateral cricoarytenoid laryngoplasty, with all procedures being performed by the same surgeon. Video images of the rima glottidis were recorded pre- and postoperatively using video endoscopy. Video images were digitized and the area of the rima glottidis measured using image-analysis software. An increase in the area of the rima glottidis was expressed as a percentage of the preoperative area. All animals were reassessed 6 weeks' postoperatively, and exercise tolerance tests were repeated.
The mean increase in the area of the rima glottidis postoperatively when compared with the preoperative area was 140% for those animals undergoing unilateral thyroarytenoid lateralization (range, 120%-158%) and 207% for those animals undergoing unilateral cricoarytenoid laryngoplasty (range, 183%-228%). This difference was statistically significant (P < .0001). At the 6-week postoperative examination, there was no significant difference in improvement between the 2 groups when compared on either a clinical basis or exercise tolerance tests. The mean surgical time in the 2 groups was 25 minutes for thyroarytenoid lateralization and 43 minutes for cricoarytenoid laryngoplasty. This was a statistically significant difference (P = .002).
Although increase in area of the rima glottidis was significantly greater after unilateral cricoarytenoid laryngoplasty compared with unilateral thyroarytenoid lateralization, no difference in clinical outcome could be detected. However, the cricoarytenoid laryngoplasty procedure required significantly more surgical time.
Both unilateral cricoarytenoid laryngoplasty and unilateral thyroarytenoid lateralization are successful methods for the treatment of laryngeal paralysis; however, thyroarytenoid lateralization requires less surgical time to perform.
比较单侧甲杓肌外移术与单侧环杓关节成形术治疗犬喉麻痹的临床效果。研究设计——一项前瞻性临床试验。
1997年至1999年间收治于格拉斯哥大学兽医院（GUVH）的20只客户拥有的犬，诊断为喉麻痹。
对每只犬进行全面评估，包括病史、体格和神经学检查、全血细胞计数、血清生化指标、血清甲状腺素（T4）水平及促甲状腺激素（TSH）测定。通过评估静息及轻度运动5分钟后的呼吸频率和动脉血气分析，研究每只犬的运动耐量。基于在轻度麻醉患者中通过喉镜内镜观察做出的喉麻痹明确诊断，将动物纳入研究。动物被随机分为2个治疗组之一：单侧甲杓肌外移术或单侧环杓关节成形术，所有手术均由同一位外科医生进行。使用视频内镜记录声门裂术前和术后的视频图像。视频图像数字化后，使用图像分析软件测量声门裂面积。声门裂面积增加量以术前面积的百分比表示。所有动物在术后6周进行重新评估，并重复运动耐量测试。
单侧甲杓肌外移术的动物术后声门裂面积较术前平均增加140%（范围120% - 158%），单侧环杓关节成形术的动物术后声门裂面积较术前平均增加207%（范围183% - 228%）。这一差异具有统计学意义（P <.0001）。在术后6周检查时，从临床或运动耐量测试方面比较，两组之间的改善无显著差异。两组的平均手术时间，甲杓肌外移术为25分钟，环杓关节成形术为43分钟。这是一个具有统计学意义的差异（P =.002）。
尽管单侧环杓关节成形术后声门裂面积的增加明显大于单侧甲杓肌外移术，但在临床结果上未检测到差异。然而，环杓关节成形术所需的手术时间明显更长。
单侧环杓关节成形术和单侧甲杓肌外移术都是治疗喉麻痹的成功方法；然而，甲杓肌外移术实施所需的手术时间更少。
