Kanebayashi Hidenori, Tokashiki Ryoji, Hiramatsu Hiroyuki, Tsukahara Kiyoaki, Motohashi Rei, Nakamura Kazuhiro, Suzuki Mamoru
Department of Otorhinolaryngology, Tokyo Medical University.
Nihon Jibiinkoka Gakkai Kaiho. 2006 Aug;109(8):655-9. doi: 10.3950/jibiinkoka.109.655.
In general, laryngoplasty for unilateral vocal cord paralysis is performed under local anesthesia because the patient's voice must be heard and the movement of the vocal cords visualized during the endoscopic procedure to ensure good results. We encountered two cases who could not endure a long operation under local anesthesia and the insertion of an endoscope because of their age and gag reflex. We thus performed a combined lateral cricoarytenoid muscle pull (LCA-pull) and a type I thyroplasty under general anesthesia applied using a laryngeal mask. Although the patients could not phonate during the operation, the laryngeal mask allowed the vocal cords to be observed. Both patients achieved in maximal phonation time over 13 seconds, and the postoperative mean flow rates improved to under 110 mL/s. The postoperative period perturbation quotient and amplitude perturbation quotient also improved to within the normal limits.
一般来说，单侧声带麻痹的喉成形术在局部麻醉下进行，因为在内镜手术过程中必须听到患者的声音并观察声带的运动，以确保良好的效果。我们遇到两例患者，由于年龄和咽反射的原因，无法在局部麻醉和插入内窥镜的情况下耐受长时间手术。因此，我们在使用喉罩进行全身麻醉下进行了联合环杓侧肌牵拉（LCA牵拉）和I型甲状成形术。尽管患者在手术过程中无法发声，但喉罩使声带得以观察。两名患者的最大发声时间均达到13秒以上，术后平均流速提高到110 mL/s以下。术后的周期扰动商和幅度扰动商也改善到正常范围内。
