Bihari A, Mészáros K, Reményi A, Lichtenberger G
Department of ORL and Head and Neck Surgery, Szent Rókus Hospital and Institutions, Gyulai Pál u.2, 1085 Budapest, Hungary.
Eur Arch Otorhinolaryngol. 2006 Dec;263(12):1115-20. doi: 10.1007/s00405-006-0116-9. Epub 2006 Aug 9.
The aim of this study was to objectively evaluate the voices of patients suffering from unilateral vocal cord paralysis, before and after endoscopic augmentation and thyroplasty. In the past, we used injectable Teflon to treat this condition; later techniques included collagen injection and Isshiki thyroplasty. In the last 7 years, preferred treatment methods have included Bioplastique injection and lipoaugmentation of the vocal cords as well as medialization thyroplasty using a titanium implant according to Friedrich. Pre- and postoperative data was evaluated and compared to 25 patients. Appropriate glottic closure of the vocal cords was achieved in every case, in most cases after the first intervention. We used voice range profile measurements to evaluate the results. An objective evaluation was performed using the Friedrich dysphonia index. Significant improvements were found: the dysphonia index decreased in every case, from an average of 2.47, preoperatively, to an average of 1.18 postoperatively. In agreement with earlier studies, voice pitch range was the only parameter that not significantly improved. There was no statistical difference between the lipoaugmentation and thyroplasty according to Friedrich. We concluded that both endoscopic methods and thyroplasty can be used to achieve an optimal result. Cases must be evaluated individually so that the best technique, or combination of methods can be determined.
本研究的目的是客观评估单侧声带麻痹患者在内镜下填充和甲状成形术前及术后的嗓音情况。过去，我们使用可注射的聚四氟乙烯治疗这种疾病；后来的技术包括胶原蛋白注射和Isshiki甲状成形术。在过去7年中，首选的治疗方法包括注射Bioplastique、声带脂肪填充以及根据Friedrich方法使用钛植入物进行甲状软骨内移术。对25例患者的术前和术后数据进行了评估和比较。在每种情况下，大多数在首次干预后都实现了声带的适当声门闭合。我们使用嗓音音域图测量来评估结果。使用Friedrich发声障碍指数进行客观评估。发现有显著改善：发声障碍指数在每种情况下均下降，从术前的平均2.47降至术后的平均1.18。与早期研究一致，嗓音音高范围是唯一未显著改善的参数。根据Friedrich方法，脂肪填充和甲状成形术之间没有统计学差异。我们得出结论，内镜方法和甲状成形术均可用于获得最佳效果。必须对病例进行个体评估，以便确定最佳技术或方法组合。
