Ford C N, Bless D M, Loftus J M
Department of Surgery, University of Wisconsin, Madison 53792.
Ann Otol Rhinol Laryngol. 1992 Mar;101(3):237-47. doi: 10.1177/000348949210100307.
Injectable bovine collagen has been used for treatment of glottic insufficiency at the University of Wisconsin Clinical Science Center since 1983. This report reviews our experience in treating 119 patients with a variety of vocal fold disorders manifested by glottic insufficiency. Many of the patients were referred because of prior treatment failures or problems that were impossible to treat with other modalities. Results were assessed by comprehensive voice evaluations using subjective patient self-assessments, perceptual judgments made by a panel of experts who had no prior knowledge of the study, objective assessments, and videostroboscopy. Objective assessment included vocal function measures and acoustic analysis. Results indicate that collagen not only is comparable to other injection filler substances but also has unique advantages as a bioimplant. Collagen injection seems uniquely suited for treatment of several problems, including vocal fold atrophy, focal defects, minimal glottic insufficiency, and scarred vocal folds that are not managed optimally with Teflon injection. Overall there were no serious complications and treatment was effective for a broad spectrum of problems. In most instances the correction persisted, and in those instances in which injected collagen seemed improperly distributed, the vocal fold was recontoured or the implant removed without appreciable damage to the surrounding tissues. Injectable collagen has been extensively studied and deserves to be included in the armamentarium of the laryngeal surgeon.
自1983年以来，威斯康星大学临床科学中心一直使用可注射牛胶原蛋白治疗声门功能不全。本报告回顾了我们治疗119例因各种声门功能不全表现的声带疾病患者的经验。许多患者是由于先前治疗失败或无法用其他方法治疗的问题而被转诊的。通过使用患者主观自我评估、由对该研究不知情的专家小组进行的感知判断、客观评估和频闪喉镜检查的综合嗓音评估来评估结果。客观评估包括嗓音功能测量和声学分析。结果表明，胶原蛋白不仅与其他注射填充物质相当，而且作为一种生物植入物具有独特的优势。胶原蛋白注射似乎特别适合治疗多种问题，包括声带萎缩、局灶性缺损、轻度声门功能不全以及用聚四氟乙烯注射无法最佳处理的瘢痕化声带。总体而言，没有严重并发症，治疗对广泛的问题有效。在大多数情况下，矫正效果持续存在，而在那些注射的胶原蛋白似乎分布不当的情况下，可以重新塑形声带或取出植入物，而不会对周围组织造成明显损伤。可注射胶原蛋白已得到广泛研究，值得纳入喉科医生的治疗手段中。
