Xu Wen, Han Demin, Hu Huiying, Chen Xuejun, Li Hongyan, Hou Lizhen, Zhang Li
Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, Beijing 100730, China.
Head Neck. 2009 Jun;31(6):732-7. doi: 10.1002/hed.21024.
Stenosis of the glottis can influence both phonation and respiration. The management of laryngeal web is difficult because of the tendency of readhesion to recur locally.
Twenty-five patients with web from the anterior glottis to the entire membranous portion of the vocal folds were included. All patients underwent endoscopic mucosal suturing or combined with placement of laryngeal silastic sheet stents.
Eight patients underwent suture of the vocal fold alone. Seventeen patients underwent suture of the vocal fold combined with silastic sheet placement. The vocal assessment of the perceptual Grade, Roughness, Breathiness, Aesthenia, Strain (GRBAS) scale, Voice Handicap Index scores, and maximum phonation time are significantly improved after surgery. Vibration of the vocal folds is normal or close to normal in 23 patients. The patients who were initially tracheotomy dependent were all decannulated.
Endoscopic suture of the vocal fold and placement of a laryngeal stent can make successful outcomes for laryngeal web.
声门狭窄会影响发声和呼吸。由于局部再粘连复发的倾向,喉蹼的治疗较为困难。
纳入25例从声门前部至声带整个膜部有蹼的患者。所有患者均接受了内镜下黏膜缝合或联合放置喉硅橡胶片支架。
8例患者仅接受了声带缝合。17例患者接受了声带缝合联合硅橡胶片放置。术后,通过嗓音评估的感知分级、粗糙度、气息声、无力、紧张(GRBAS)量表、嗓音障碍指数评分和最长发声时间均有显著改善。23例患者的声带振动正常或接近正常。最初依赖气管切开术的患者均已拔管。
内镜下声带缝合及喉支架置入可使喉蹼治疗取得成功。