Sanuki Tetsuji, Isshiki Nobuhiko
Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kumamoto University, 1-1-1 Honjyo, Kumamoto, Japan.
Acta Otolaryngol. 2009 Nov;129(11):1287-93. doi: 10.3109/00016480802620639.
The factors responsible for the observed failures can be broken into two major groups: (1) a wrong indication and (2) an inadequate technique to achieve relief from an excessively tight glottal closure. The use of a titanium bridge in place of a silicone shim was found to be essential. Type II thyroplasty can relieve the symptoms of adductor spasmodic dysphonia (AdSD) when implemented with a modern technique using titanium bridges.
To identify the factor or factors that necessitated revision surgery in type II thyroplasty for AdSD, detailed analytical examinations were made of individual cases with unsatisfactory outcomes.
A retrospective analysis of a case series with follow-up periods of 2-5 years.
Ninety AdSD patients underwent type II thyroplasty. The results in one patient were limited because a pathological mechanism other than AdSD was also involved. One patient, a singer, who wanted a more intense voice for singing was dissatisfied with the results. In three patients, the material used for fixation was inadequate. In two other patients, the method of application of the fixative material was found to be insufficient as it did not include both the upper and lower sides.
导致观察到的手术失败的因素可分为两大类：（1）适应证错误；（2）技术不足，无法缓解因声门过度紧闭所致的症状。发现使用钛桥替代硅胶垫片至关重要。采用现代技术使用钛桥进行II型甲状成形术可缓解内收型痉挛性发声障碍（AdSD）的症状。
为确定II型甲状成形术治疗AdSD后需要翻修手术的一个或多个因素，对结局不满意的个体病例进行了详细的分析检查。
对一个随访期为2至5年的病例系列进行回顾性分析。
90例AdSD患者接受了II型甲状成形术。1例患者的结果有限，因为还涉及AdSD以外的病理机制。1例歌手患者希望唱歌时声音更洪亮，对结果不满意。3例患者中，用于固定的材料不足。另外2例患者中，发现固定材料的应用方法不够充分，因为未包括上下两侧。
