Szkiełkowska Agata, Miaśkiewicz Beata, Remacle Marc, Skarzyński Henryk
Klinika Audiologii i Foniatrii Instytutu Fizjologii i Patologii Słuchu w Warszawie.
Otolaryngol Pol. 2011 Nov-Dec;65(6):436-42. doi: 10.1016/S0030-6657(11)70737-5.
Method of vocal folds implantation with allogenic materials has been applied in medical centre all over the world for over 30 years. this voice improving method is usually applied in several indications such as: presbyphonia, vocal folds paralysis, glottis insufficiency, vocal fold scars or sulcus vocalis. all of these illnesses prevent the patients to obtain full glottis closure and produce good quality voice.
TO assess quality of voice after implantation of hyaluronic acid to the vocal folds.
Consisted of 15 patients, who underwent surgical implantation of hyaluronic acid to the vocal folds. 10 patients had the procedure performed on both sides of the larynx, this group included 6 patients with vocal insufficiency of the glottis, 2 with scars and atrophy of the vocal folds and 2 with presbyphonia. In 5 cases the hyaluronic acid was applied on one side of the larynx. The group included 4 patients with vocal folds paralysis and one person with single sided scars and atrophy of the vocal fold.
Each patient was examined with videostroboscopy and underwent objective and subjective assessment of voice. Hyaluronic acid was injected surgically under Jet Ventilation general anesthesia. In two cases during the procedure scars were removed from the vocal folds. All patients after hyaluronic acid augmentation took part in the rehabilitation program that included series of voice emission exercises before operation and up to 3 months after the procedure. Examination was performed 1, 3 and 6 months after injection.
In all cases improvement of quality of voice was obtained which was stated by a physician and the patients subjectively. Improvement of harmonic voice structure was confirmed by spectrographic record. Acoustic examinations revealed that the improvement was obtained within parameters describing frequency, amplitude disturbance and noise existence.
Injection of the hyaluronic acid to the vocal folds improves functional phonation and quality of voice in cases of patients with glottis insufficiency. Injection of the hyaluronic acid to the vocal folds is an efficient method improving quality of voice and can be safe alternative for no surgery method in rehabilitation of voice. This method is a simply, effective and quickly to improve of voice disorders.
同种异体材料声带植入方法已在世界各地的医疗中心应用了30多年。这种改善嗓音的方法通常适用于多种病症，如：老年嗓音障碍、声带麻痹、声门闭合不全、声带瘢痕或声带沟。所有这些疾病都使患者无法实现完全声门闭合，无法发出高质量的声音。
评估向声带注射透明质酸后的嗓音质量。
由15名接受声带透明质酸手术植入的患者组成。10名患者在喉部两侧进行了该手术，该组包括6名声门闭合不全患者、2名声带瘢痕和萎缩患者以及2名老年嗓音障碍患者。5例患者在喉部一侧注射了透明质酸。该组包括4名声带麻痹患者和1名单侧声带瘢痕及萎缩患者。
对每位患者进行频闪喉镜检查，并对嗓音进行客观和主观评估。在喷射通气全身麻醉下手术注射透明质酸。2例手术过程中切除了声带瘢痕。所有接受透明质酸增强治疗后的患者都参加了康复计划，该计划包括术前及术后3个月内的一系列发声练习。注射后1、3和6个月进行检查。
在所有病例中，医生和患者主观上均表明嗓音质量得到改善。频谱记录证实了谐波嗓音结构的改善。声学检查显示，在描述频率、振幅干扰和噪声存在的参数范围内获得了改善。
向声带注射透明质酸可改善声门闭合不全患者的功能性发声和嗓音质量。向声带注射透明质酸是一种改善嗓音质量的有效方法，并且在嗓音康复中可作为非手术方法的安全替代方案。该方法简单、有效且能快速改善嗓音障碍。
