Zeitels Steven M, Mauri Marcelo, Dailey Seth H
Department of Otology and Laryngology, Harvard Medical School, and Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA.
Ann Otol Rhinol Laryngol. 2003 Feb;112(2):180-4. doi: 10.1177/000348940311200213.
Gore-Tex has been used as an effective implant for medialization laryngoplasty in the management of paralytic dysphonia; however, reporting of large patient cohorts has been limited. Furthermore, the use of Gore-Tex in the treatment of glottal incompetence secondary to soft tissue defects has not yet been described. Finally, a number of the procedural nuances of using Gore-Tex have not been elucidated. A prospective investigation was done on 142 patients who underwent 152 Gore-Tex medialization laryngoplasties in 183 vocal folds from December 1997 to March 2002. The primary diagnoses prompting the 152 procedures were paralysis in 94, paresis in 18, cancer reconstruction in 14, sulcus vocalis in 6, atrophy in 3, trauma defect in 5, arytenoid dislocation in 3, bilateral paralysis in 3, bilateral paresis in 1, parkinsonism in 4, and neurologic aerodynamic dissociation in 1. One patient who underwent reconstruction of a complex cancer defect required endoscopic removal of the Gore-Tex because of persistent granulation. Clinical observations reveal that Gore-Tex is a versatile implant that is ideally suited for phonosurgical reconstruction of aerodynamic glottal incompetence secondary to a variety of causes. Gore-Tex was especially useful for medialization of complex anatomic soft tissue defects such as those resulting from cancer resection, trauma, atrophy, and sulcus vocalis. There was superior ease in handling, placement, and in vivo adjustability.
在麻痹性发音障碍的治疗中，戈尔特斯（Gore-Tex）已被用作一种有效的喉内移植物进行喉整复术；然而，关于大量患者队列的报道有限。此外，尚未有关于使用戈尔特斯治疗继发于软组织缺损的声门闭合不全的描述。最后，使用戈尔特斯的一些手术细微差别尚未阐明。对1997年12月至2002年3月期间接受152次戈尔特斯喉内移植物植入术、涉及183个声带的142例患者进行了一项前瞻性研究。促使进行这152例手术的主要诊断包括：94例麻痹、18例轻瘫、14例癌症重建、6例声带沟、3例萎缩、5例创伤缺损、3例杓状软骨脱位、3例双侧麻痹、1例双侧轻瘫、4例帕金森病和1例神经动力学解离。1例接受复杂癌症缺损重建的患者因持续性肉芽组织形成而需要在内镜下取出戈尔特斯。临床观察表明，戈尔特斯是一种多功能移植物，非常适合对继发于多种原因的气动性声门闭合不全进行嗓音外科重建。戈尔特斯对于复杂的解剖学软组织缺损（如癌症切除、创伤、萎缩和声带沟导致的缺损）的内移尤其有用。在操作、放置和体内可调节性方面具有卓越的便利性。
