Hsieh Yi-Ling, Chang Ming-Hong, Wang Chen-Chi
Department of Otolaryngology - Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
Head Neck. 2014 Jun;36(6):867-72. doi: 10.1002/hed.23388. Epub 2013 Sep 2.
The clinical features of vocal fold immobility (VFI) after radiotherapy for nasopharyngeal carcinoma (NPC) have seldom been reported.
We retrospectively reviewed laryngeal electromyography (LEMG) and tumor study findings to elucidate the common clinical features of patients who presented with VFI after radiotherapy for NPC. The LEMG signals obtained from the cricothyroid and thyroarytenoid muscles were used to confirm superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN) injury.
The medical records of 13 patients were reviewed and 11 of them had evidence of RLN injury. Six of the 11 patients also had SLN injury, indicating possible vagus nerve (VN) injury. Two patients had cricoarytenoid joint fixation without evidence of nerve injury. None of the nerve injuries were caused by skull base recurrence or tumor metastasis.
VFI is usually caused by nerve injury, but it is not a malignant sign of tumor recurrence or metastasis.
鼻咽癌（NPC）放疗后声带麻痹（VFI）的临床特征鲜有报道。
我们回顾性分析了喉肌电图（LEMG）和肿瘤研究结果，以阐明鼻咽癌放疗后出现VFI患者的常见临床特征。从环甲肌和甲杓肌获得的LEMG信号用于确认喉上神经（SLN）和喉返神经（RLN）损伤。
回顾了13例患者的病历，其中11例有RLN损伤证据。11例患者中有6例也有SLN损伤，提示可能存在迷走神经（VN）损伤。2例患者出现环杓关节固定，但无神经损伤证据。所有神经损伤均非由颅底复发或肿瘤转移所致。
VFI通常由神经损伤引起，但并非肿瘤复发或转移的恶性征象。
