Sittel C, Bosch N, Plinkert P K
Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart - Katharinenhospital, Kriegsbergstrasse 60, 70174, Stuttgart.
Chirurg. 2008 Nov;79(11):1055-64. doi: 10.1007/s00104-008-1550-6.
Unilateral recurrent nerve paralysis leads to glottic insufficiency, significantly reducing vocal ability. Due to its unusually long course, the recurrent laryngeal nerve is prone to iatrogenic lesions involves many medical fields generally with little expertise in voice disorders. Whenever the etiology is uncertain, a complete diagnostic work-up is mandatory. Indirect laryngoscopy confirms the diagnosis. Laryngeal electromyography is of great value because it differentiates between paralysis and ankylosis of the cricoarytenoid joint. Moreover in many cases laryngeal electromyography yields a reliable prognosis of clinical outcome. While unfavorable results can be predicted with high accuracy, correct prognosis of complete recovery is more difficult. Speech therapy is the treatment of choice in cases of unilateral recurrent nerve palsy. Patients with persistent glottal gap may express the wish for surgical voice rehabilitation. Nowadays a broad spectrum of endoscopic and open approaches are available for this purpose. This review describes advanced techniques of voice-improving surgery available in specialized centers today.
单侧喉返神经麻痹会导致声门功能不全，显著降低发声能力。由于喉返神经行程异常长，容易发生医源性损伤，涉及许多医学领域，而这些领域的医生通常对嗓音疾病了解甚少。每当病因不明时，必须进行全面的诊断检查。间接喉镜检查可确诊。喉肌电图具有重要价值，因为它能区分环杓关节麻痹和关节强直。此外，在许多情况下，喉肌电图能对临床结果给出可靠的预后判断。虽然可以高精度预测不良结果，但准确预测完全恢复则较为困难。言语治疗是单侧喉返神经麻痹病例的首选治疗方法。声门间隙持续存在的患者可能希望接受手术嗓音康复治疗。如今，有多种内镜和开放手术方法可用于此目的。本综述介绍了当今专业中心可用的先进嗓音改善手术技术。
