Smith Marshall E, Roy Nelson, Stoddard Kelly
Division of Otolaryngology, Head and Neck Surgery, Primary Children's Medical Center, University of Utah School of Medicine, The University of Utah, 3C-120 SOM, 50N. Medical Dr., Salt Lake City, UT 84132, United States.
Int J Pediatr Otorhinolaryngol. 2008 Sep;72(9):1311-6. doi: 10.1016/j.ijporl.2008.05.004. Epub 2008 Jun 30.
OBJECTIVE/HYPOTHESIS: To assess the outcomes of management of unilateral vocal fold paralysis by ansa-RLN reinnervation in a series of patients ages 12-21.
Clinical outcomes study.
Six consecutive adolescents and young adults (ages 12-21 years) seeking treatment for unilateral vocal fold paralysis and glottal incompetence underwent ansa-RLN neurorraphy. Pre- and post-operative voice recordings acquired at least 1 year following surgery were submitted to acoustic and perceptual analysis. Patient-based measures were also taken.
Mean perceptual visual analogue scale rating of dysphonia severity (0mm=profoundly abnormal voice, 100mm=completely normal voice) improved from 50mm pre-operatively to 82mm post-operatively. Mean maximum phonation time improved from 6.5s to 13.2s. Pitch and dynamic range were also observed to improve. Global self-ratings of voice function (0-100%) increased from 31.2% to 81.6% of normal.
Ansa-RLN reinnervation is an effective treatment option for adolescents and young adults with unilateral vocal fold paralysis. The procedure has the potential to improve vocal function substantially, especially in those with isolated paralysis of the recurrent laryngeal nerve. The procedure alleviates the disadvantages associated with other surgical options for this age group.
目的/假设：评估在一系列12至21岁患者中，采用舌下神经袢-喉返神经（ansa-RLN）再支配术治疗单侧声带麻痹的效果。
临床疗效研究。
连续6例因单侧声带麻痹和声门功能不全寻求治疗的青少年及青年（年龄12至21岁）接受了舌下神经袢-喉返神经神经吻合术。术后至少1年采集的术前和术后语音记录进行声学和感知分析。还采用了基于患者的测量方法。
发音障碍严重程度的平均感知视觉模拟量表评分（0mm = 声音严重异常，100mm = 声音完全正常）从术前的50mm提高到术后的82mm。平均最长发声时间从6.5秒提高到13.2秒。音高和动态范围也有所改善。声音功能的总体自我评分（0 - 100%）从正常的31.2%提高到81.6%。
舌下神经袢-喉返神经再支配术是治疗青少年及青年单侧声带麻痹的有效治疗选择。该手术有可能显著改善发声功能，尤其是对于那些喉返神经孤立性麻痹的患者。该手术减轻了该年龄组其他手术选择相关的缺点。
