Shiotani Akihiro, Okubo Keisuke, Saito Koichiro, Fujimine Takekatsu, Tomifuji Masayuki, Ikeda Asako, Araki Koji, Momoshima Suketaka
Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan.
Otolaryngol Head Neck Surg. 2009 Jun;140(6):816-21. doi: 10.1016/j.otohns.2009.01.040. Epub 2009 Mar 28.
To assess the feasibility of injection laryngoplasty with calcium phosphate cement (CPC), which is an injectable paste, self-hardening, and which recrystallizes to calcium hydroxylapatite after injection.
A case series with planned data collection.
Fifty-six patients with unilateral vocal fold paralysis, who received injection laryngoplasty with CPC between August 2003 and August 2007 with a minimum follow-up period of six months, were enrolled in this study. Volumetric and migration analysis for injected CPC were performed using CT after surgery. Vocal function was also assessed by GRBAS subjective voice assessment scale and maximum phonation time (MPT), acoustic analysis including period perturbation quotient (PPQ), amplitude perturbation period (APQ), and noise-to-harmonics ratio (NHR).
No remarkable migration or absorption of injected CPC was observed on CT up to two years after surgery. The average remaining volume of CPC was 87.8% +/- 5.3% two years after injection compared to immediately after injection. Significant improvements in GRBAS scales, MPT, PPQ, APQ, and NHR were observed postoperatively. No adverse effects were observed.
Our clinical experience revealed that CPC was safe, nonabsorbable, and effective. Injection laryngoplasty with CPC may be a useful option in the treatment of glottic insufficiency.
评估使用磷酸钙骨水泥（CPC）进行注射喉成形术的可行性，该骨水泥为可注射糊剂，能自行硬化，注射后重结晶为羟基磷灰石。
带有计划数据收集的病例系列研究。
纳入56例单侧声带麻痹患者，这些患者于2003年8月至2007年8月间接受了CPC注射喉成形术，且随访期至少为6个月。术后使用CT对注射的CPC进行体积和移位分析。还通过GRBAS主观嗓音评估量表和最长发声时间（MPT）评估嗓音功能，通过声学分析包括周期扰动商（PPQ）、幅度扰动周期（APQ）和噪声与谐波比（NHR）进行评估。
术后两年内CT检查未观察到注射的CPC有明显移位或吸收。与注射后即刻相比，注射两年后CPC的平均剩余体积为87.8%±5.3%。术后GRBAS量表、MPT、PPQ、APQ和NHR均有显著改善。未观察到不良反应。
我们的临床经验表明，CPC安全、不可吸收且有效。CPC注射喉成形术可能是治疗声门闭合不全的一种有效选择。
