Cohen Seth M, Garrett C Gaelyn, Netterville James L, Courey Mark S
Vanderbilt Voice Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Ann Otol Rhinol Laryngol. 2006 Jun;115(6):439-43. doi: 10.1177/000348940611500607.
This study explores whether videoendoscopic findings and patient history help make the diagnosis in bilateral vocal fold immobility (BVFI).
Medical records from 1995 to 2003 were searched to identify patients with posterior glottic stenosis (PGS) and bilateral vocal fold paralysis (BVFP) who also had videoendoscopic examinations. Videoendoscopic examination findings that could help differentiate PGS from BVFP were identified a priori. A weighted scoring index, based on the adjusted odds ratios of significant examination findings on multiple logistic regression, was derived. Associations between the weighted scoring index, patient history, and diagnosis were then evaluated.
Twenty-six patients with BVFP and 28 patients with PGS were identified. Posterior glottic scar (weight = 2), medial arytenoid erosion with a widened posterior glottis (weight = 1), and appropriate vocal fold motion (weight = 1) were significant variables (p < or = .05, multiple logistic regression) and constituted the weighted scoring index. A weighted scoring index of > or = 2 and a history of prolonged intubation predicted PGS in 95.2% of cases. A weighted scoring index of < or = 1 and a history of neck surgery predicted BVFP in 95.0% of cases.
The weighted scoring index with the patient history provides an objective tool for diagnosing BVFI.
本研究探讨视频内镜检查结果及患者病史是否有助于双侧声带麻痹（BVFI）的诊断。
检索1995年至2003年的病历，以确定患有后声门狭窄（PGS）和双侧声带麻痹（BVFP）且接受过视频内镜检查的患者。预先确定有助于区分PGS与BVFP的视频内镜检查结果。基于多元逻辑回归中显著检查结果的调整比值比得出加权评分指数。然后评估加权评分指数、患者病史与诊断之间的关联。
确定了26例BVFP患者和28例PGS患者。后声门瘢痕（权重 = 2）、杓状软骨内侧糜烂伴后声门增宽（权重 = 1）以及适当的声带运动（权重 = 1）是显著变量（p≤0.05，多元逻辑回归），并构成加权评分指数。加权评分指数≥2且有长期插管史可在95.2%的病例中预测PGS。加权评分指数≤1且有颈部手术史可在95.0%的病例中预测BVFP。
结合患者病史的加权评分指数为诊断BVFI提供了一种客观工具。
