Kanebayashi Hidenori, Tokashiki Ryoji, Hiramatsu Hiroyuki, Suzuki Mamoru
Department of Otorhinolaryngology, Tokyo Medical University, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 2006 Feb;109(2):84-7. doi: 10.3950/jibiinkoka.109.84.
Techniques and the outcome of our approach that combined two operations, a direct pull of the lateral cricoarytenoid muscle (LCA-Pull) and Isshiki's thyroplasty type I are reported. LCA-Pull is very simple and allows natural adduction of arytenoid by pulling LCA. The subjects were five patients whose maximal phonation time (MPT) were under 5 seconds. All patients achieved MPT over 13 seconds. Mean flow rates (MFR) varied from 340ml/s to over 1000 ml/s before the operation. In all patients, the post operative MFR improved to under 150 ml/s. Sometimes severe unilateral vocal cord paralysis requires both arytenoid adduction and medialization thyroplasty to obtain good voice. Combination of LCA-Pull and thyroplasty type I is very effective for severe case, and could be done in the same operating field by creating an additional window in the thyroid ala.
本文报告了一种联合两种手术操作的方法及其结果，即环杓侧肌直接牵拉术（LCA-Pull）和石氏I型甲状软骨成形术。LCA-Pull操作非常简单，通过牵拉环杓侧肌可使杓状软骨自然内收。研究对象为5名最大发声时间（MPT）不足5秒的患者。所有患者术后MPT均超过13秒。术前平均流速（MFR）在340ml/s至超过1000ml/s之间。所有患者术后MFR均改善至150ml/s以下。有时严重的单侧声带麻痹需要同时进行杓状软骨内收术和甲状软骨成形术以获得良好嗓音。LCA-Pull和I型甲状软骨成形术联合应用对严重病例非常有效，并且可以通过在甲状软骨翼上额外开窗在同一手术区域完成。
