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早期声门型喉癌治疗后构成声源的结构。

Structures constituting the sound source after the treatment of early glottic cancer.

机构信息

School of Medicine, Fundação Lusíada, Santos, São Paulo, Brazil.

出版信息

J Voice. 2011 Jan;25(1):e47-51. doi: 10.1016/j.jvoice.2009.10.008. Epub 2010 Feb 26.

Abstract

INTRODUCTION

We indicate the exclusive radiation therapy as initial approach for T1a glottic tumors, and the frontolateral laryngectomy for the tumors staged as T1b and selected T2 glottic tumors. The videolaryngostroboscopy is a useful tool to analyze the laryngeal structural changes and compensatory motion after the therapeutic approach.

OBJECTIVES

To evaluate the endolaryngeal structures of patients who participate in the vibratory sound source after the early glottic cancer treatment through the videolaryngostroboscopy.

METHODS

It was a retrospective transversal study in which 20 patients who underwent exclusive radiation therapy and 25 patients who underwent frontolateral laryngectomy were analyzed by means of videolaryngostroboscopy. The radiation doses ranged from 5000 to 7020 cGy in the radiation therapy group. The mucosal wave and the vibratory source components were evaluated.

RESULTS

All of the irradiated patients presented vibratory behavior, and hyperfunction was occasionally observed in four cases. The mucosal wave source was glottic in 18 cases and mixed in two cases. In the laryngectomy group, 10 supraglottic sources, 10 glottic sources, and five mixed sources were identified. Among the 10 cases of supraglottic source, eight patients presented global constriction and two patients presented medial constriction. Among the five cases of mixed source, two patients presented global constriction, one patient presented medial constriction, and one patient presented anteroposterior constriction. Regarding the number of anatomical structures presenting vibratory pattern, five patients had two structures, four patients had three structures, and one patient had four structures.

CONCLUSION

Patients who underwent radiation therapy recruit less supraglottic structures as vibratory source than the patients undergoing vertical laryngectomy.

摘要

简介

我们建议对 T1a 声门型肿瘤采用单纯放疗作为初始治疗方法,对 T1b 期肿瘤和部分 T2 声门型肿瘤采用喉前外侧切除术。频闪喉镜是一种有用的工具,可以分析治疗后喉部结构的变化和代偿运动。

目的

通过频闪喉镜评估早期声门型喉癌患者接受治疗后声带振动源的内喉结构。

方法

这是一项回顾性的横断研究,分析了 20 例接受单纯放疗和 25 例接受喉前外侧切除术的患者。放疗组的放疗剂量为 5000-7020cGy。评估了黏膜波和振动源成分。

结果

所有接受放疗的患者均表现出振动行为,偶尔有 4 例出现过强收缩。18 例黏膜波源为声门型,2 例为混合型。在喉切除术组中,确定了 10 个声门上源、10 个声门源和 5 个混合源。在 10 个声门上源病例中,8 例患者表现为全喉收缩,2 例患者表现为内收。在 5 个混合源病例中,2 例患者表现为全喉收缩,1 例患者表现为内收,1 例患者表现为前后收缩。关于表现出振动模式的解剖结构数量,5 例患者有两个结构,4 例患者有三个结构,1 例患者有四个结构。

结论

与接受垂直喉切除术的患者相比,接受放疗的患者作为振动源募集的声门上结构较少。

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