Sercarz J A, Berke G S, Ming Y, Gerratt B R, Natividad M
Division of Head and Neck Surgery, University of California-Los Angles Medical Center.
Ann Otol Rhinol Laryngol. 1992 Jul;101(7):567-77. doi: 10.1177/000348949210100705.
Previous stroboscopic studies of human vocal cord paralysis have been infrequent and have lacked documentation of the site of lesion. In order to study human laryngeal paralysis, the recurrent and superior laryngeal nerves were infiltrated unilaterally with lidocaine hydrochloride in three human volunteers. Vagal paralysis was simulated by combined (superior and recurrent) infiltration in one volunteer. Additionally, 20 patients with untreated laryngeal paralysis were studied from the voice laboratory at UCLA. In addition to videostroboscopic analysis, photoglottography and electroglottography were performed and synchronized with the stroboscopic images. The most significant finding in stroboscopy of the paralyzed larynx was the asymmetry of traveling wave motion. The traveling wave on the normal vocal fold had a faster wave velocity that created a phase difference in the vibration of the two folds. The wave also traversed a greater distance along the vocal fold mucosa on the normal side. No patient or volunteer with untreated laryngeal paralysis had a symmetric traveling wave, either in superior or recurrent laryngeal nerve paralysis. Synchronization with glottography indicated that the differentiated electroglottographic waveform provides useful information about the timing of glottic opening and closure in states of asymmetric laryngeal vibration. Implications for future studies and for the diagnosis of laryngeal paralysis are discussed.
以往对人类声带麻痹的频闪研究并不常见，且缺乏病变部位的记录。为了研究人类喉麻痹，在三名志愿者身上单侧用盐酸利多卡因浸润喉返神经和喉上神经。在一名志愿者身上通过联合（喉上神经和喉返神经）浸润模拟迷走神经麻痹。此外，对加州大学洛杉矶分校语音实验室的20名未经治疗的喉麻痹患者进行了研究。除了频闪视频分析外，还进行了光声门图和电声门图检查，并与频闪图像同步。麻痹喉的频闪检查中最显著的发现是行波运动的不对称性。正常声带的行波速度更快，这在两侧声带的振动中产生了相位差。该波在正常侧沿声带黏膜传播的距离也更远。无论是喉上神经麻痹还是喉返神经麻痹，未经治疗的喉麻痹患者或志愿者均未出现对称的行波。与声门图同步显示，分化的电声门图波形为不对称喉振动状态下声门开闭的时间提供了有用信息。文中讨论了对未来研究和喉麻痹诊断的意义。
