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[喉返神经麻痹和张力减退性发音障碍气道阻力的客观测量]

[Objective measurements of airway resistance in recurrent nerve paralysis and hypotonic dysphonia].

作者信息

Schumann K, Beck C, Holm C

出版信息

Laryngol Rhinol Otol (Stuttg). 1975 Dec;54(12):969-76.

PMID:128676
Abstract

Respiratory obstructions of the glottis may be reliably diagnosed at any time with a body plethysmograph used in pulmonary function testing. While respiratory resistance at 27.1 mm H2O/l and sec was only slightly increased in 35 patients with unilateral recurrent nerve paralysis and not even perceived by most of them, considerably increased resistance was found in 65 patients with bilateral paralysis. Critical lifeendangering obstructions of the respiratory system were not observed. Intra- and extralaryngeal lateral fixations of the vocal cord were carried out in 29 subjects. We observed unrestricted breathing and alveolar ventilation with respiratory resistance of 25 to 44 mm H2O/l and sec even under physical strain. Additional optimal phoniatric results and speech function is present in this range. 14 patients operated according to the endolaryngeal method of Thornell 1948 showed the best functional results. In cases of unilateral recurrent paralysis and hypotonic dysphonia we were able to measure the glottic resistance during phonation by using the modified interruption technique. The values were clearly subnormal at a median of 65 to 79 mm H2O/l and sec. In 43 cases treated with teflon injections a 50% increase of the airway resistance during phonation was observed. These findings correlate with the positive subjective experiences of the patients.

摘要

使用肺功能测试中的体容积描记仪可随时可靠地诊断声门的呼吸阻塞情况。在35例单侧喉返神经麻痹患者中,27.1毫米水柱/升·秒时的呼吸阻力仅略有增加,大多数患者甚至未察觉到,而在65例双侧麻痹患者中发现阻力显著增加。未观察到危及生命的严重呼吸系统阻塞情况。对29名受试者进行了喉内和喉外声带固定术。我们观察到,即使在身体应激状态下,呼吸阻力为25至44毫米水柱/升·秒时,呼吸和肺泡通气仍不受限制。在此范围内还存在额外的最佳发声结果和言语功能。按照1948年索内尔的喉内方法进行手术的14例患者显示出最佳功能结果。在单侧喉返神经麻痹和张力性发声障碍的病例中,我们能够通过使用改良的中断技术在发声时测量声门阻力。其值明显低于正常,中位数为65至79毫米水柱/升·秒。在43例接受聚四氟乙烯注射治疗的病例中,观察到发声时气道阻力增加了50%。这些发现与患者的积极主观体验相关。

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