Olthoff Arno, Zeiss Daniel, Laskawi Rainer, Kruse Eberhard, Steiner Wolfgang
Dept of Phoniatrics and Pedaudiology, University of Göttingen, Robert-Koch-Str 40, D-37075 Göttingen, Germany.
Ann Otol Rhinol Laryngol. 2005 Aug;114(8):599-604. doi: 10.1177/000348940511400804.
We performed a prospective study to assess respiratory function and voice quality before and after laser microsurgical bilateral posterior cordectomy performed for chronic airway obstruction in patients with bilateral vocal fold paralysis.
In 17 patients a laser microsurgical posterior cordectomy was performed as an immediate bilateral approach. Roughness, breathiness, hoarseness, and dyspnea were evaluated both subjectively (on a scale from 0 to 3) and objectively (body plethysmography, computerized voice analysis: Göttingen Hoarseness Diagram).
After laser surgery, the patients' respiratory function was significantly increased and was sufficient for all activities of daily living. The body plethysmographic measure of airway resistance had superior descriptive power and correlated significantly with the clinical degree of dyspnea (scale 0 to 3). Pretreatment and posttreatment impairment of voice quality was objectively documented with the Göttingen Hoarseness Diagram; the phonatory results measured with it correlated significantly with the subjective clinical evaluation of hoarseness. Aphonia did not occur.
A bilateral approach for laser microsurgical posterior cordectomy combines excellent airway improvement and satisfactory voice preservation. In bilateral vocal fold paralysis, pretreatment and posttreatment clinical data should be evaluated by objective measures.
我们进行了一项前瞻性研究，以评估双侧声带麻痹患者因慢性气道阻塞接受激光显微双侧后索切除术前后的呼吸功能和嗓音质量。
对17例患者采用激光显微后索切除术作为即时双侧手术方法。从主观（0至3分）和客观（体容积描记法、计算机化嗓音分析：哥廷根嘶哑图）两方面评估粗糙感、气息声、嘶哑和呼吸困难情况。
激光手术后，患者的呼吸功能显著增强，足以满足所有日常生活活动。气道阻力的体容积描记测量具有更好的描述能力，且与呼吸困难的临床程度（0至3级）显著相关。用哥廷根嘶哑图客观记录了嗓音质量的治疗前和治疗后损伤情况；用该图测量的发声结果与嘶哑的主观临床评估显著相关。未出现失音情况。
激光显微后索切除术的双侧手术方法结合了出色的气道改善和令人满意的嗓音保留效果。在双侧声带麻痹中，治疗前和治疗后的临床数据应通过客观测量进行评估。
