Zhang Fan, Sprecher Alicia J, Wei Chunsheng, Jiang Jack J
Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University Medical School, Shanghai, China.
Otolaryngol Head Neck Surg. 2010 Aug;143(2):198-203. doi: 10.1016/j.otohns.2010.03.002. Epub 2010 Jun 8.
To evaluate the effectiveness of gelatin sponge implantation combined with the injection of autologous fat for the treatment of sulcus vocalis.
Prospective cohort study.
The research was conducted at the Eye, Ear, Nose, and Throat Hospital of Fudan University.
Twelve cases of sulcus vocalis were treated. The fibrotic tissue was dissected and a gelatin sponge was implanted into the affected vocal fold followed by injection of autologous fat. Videostroboscopy, maximum phonation time (MPT), and acoustic data were completed before and after surgery.
One month after surgery, the affected vocal fold displayed mild swelling, without evidence of a sulcus and with satisfactory glottal closure. Three months later, vocal vibration and mucosal wave were improved with the vocal fold displaying a more normal shape. Although voices did not achieve complete normalcy, the patients exhibited a better voice, with improved fundamental frequency, jitter, shimmer, normalized noise energy, and a significantly longer maximum phonation time (P < 0.05).
Implantation of gelatin sponge combined with injection of autologous fat can be used to treat sulcus vocalis. The absorbable gelatin sponge can be used to fill the superficial lamina propria temporarily to prevent the readhesion of the detached mucosa at the bottom of the sulcus to the underlying tissue, while the injected fat adequately diminishes the insufficient glottal closure.
评估明胶海绵植入联合自体脂肪注射治疗声带沟的有效性。
前瞻性队列研究。
复旦大学附属眼耳鼻喉科医院。
对12例声带沟患者进行治疗。切除纤维化组织，在患侧声带植入明胶海绵，随后注射自体脂肪。术前及术后均完成频闪喉镜检查、最长发声时间（MPT）和声门数据测量。
术后1个月，患侧声带轻度肿胀，未见声带沟，声门闭合良好。3个月后，声带振动及黏膜波改善，声带形态更接近正常。尽管嗓音未完全恢复正常，但患者嗓音状况改善，基频、抖动、闪烁、噪声能量正常化，最长发声时间显著延长（P < 0.05）。
明胶海绵植入联合自体脂肪注射可用于治疗声带沟。可吸收明胶海绵可暂时填充浅层固有层，防止声带沟底部分离的黏膜与深层组织重新粘连，而注射的脂肪可充分改善声门闭合不全。
