Heman-Ackah Yolanda D
American Institute for Voice and Ear Research and Departmentsof Otolaryngology--Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA 19103, USA.
J Voice. 2005 Sep;19(3):504-9. doi: 10.1016/j.jvoice.2004.07.004. Epub 2004 Nov 21.
This case report describes a one-stage technique for long-term voice restoration and laryngeal reconstruction in the treatment of Teflon (Dupont, Wilmington, Delaware) granuloma. A patient who presented with severe dysphonia underwent resection of a Teflon granuloma via a lateral laryngotomy. A pedicled strap muscle flap was used to reconstruct the paraglottic space. The muscle flap was positioned through the lateral laryngotomy with direct endoscopic visualization of the endolarynx to ensure correct vertical positioning and medialization of the vocal fold. The muscle flap was secured in this position with suture fixation. The trapdoor piece of cartilage that was elevated to create the window in the lateral thyroid lamina was repositioned over the pedicled muscle flap and reinforced with a titanium miniplate, which was secured to the remaining thyroid cartilage. The patient had excellent voice results and has not required revision or augmentation. Reinforcement of the lateral thyroid lamina using titanium miniplate fixation helps to stabilize the muscle pedicle flap and the position of the vocal fold, in this case resulting in good long-term voice results after a single-stage reconstruction.
本病例报告描述了一种用于治疗聚四氟乙烯(杜邦公司,特拉华州威尔明顿)肉芽肿的长期嗓音恢复和喉重建的一期技术。一名出现严重发音障碍的患者通过外侧喉切开术切除了聚四氟乙烯肉芽肿。使用带蒂带状肌瓣重建声门旁间隙。肌瓣通过外侧喉切开术放置,同时在内窥镜直视下观察喉内情况,以确保声带正确的垂直定位和内移。肌瓣通过缝线固定于此位置。将为在甲状腺外侧板上开窗而掀起的活板门状软骨片重新放置在带蒂肌瓣上方,并用微型钛板加固,微型钛板固定于剩余的甲状软骨上。该患者获得了出色的嗓音效果,无需进行翻修或补充手术。在本病例中,使用微型钛板固定加固甲状腺外侧板有助于稳定肌蒂瓣和声带位置,从而在一期重建后获得良好的长期嗓音效果。