Department of Otolaryngology, Head & Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
JAMA Otolaryngol Head Neck Surg. 2013 Jul;139(7):712-8. doi: 10.1001/jamaoto.2013.3395.
Total arytenoidectomy is claimed to increase risk of aspiration and cause more voice loss than other operations performed for bilateral abductor vocal fold paralysis (BVFP). However, objective evidence for such a conclusion is lacking. There is no study comparing swallowing and voice after total and partial arytenoidectomy.
To compare voice and swallowing parameters after endoscopic total and partial arytenoidectomy for BVFP.
DESIGN, SETTING, AND PARTICIPANTS: In this prospective, randomized, double-blind, case-control study conducted at a tertiary referral university, the study population comprised 20 patients with BVFP.
Endoscopic total and partial arytenoidectomy.
Decannulation, duration of operation, Voice Handicap Index, acoustic and aerodynamic analysis, postoperative breathing ability, subjective comparison of preoperative and postoperative voice, speech intensity, and functional outcome swallowing scale.
Median duration of partial and total arytenoidectomies were 59 and 49 minutes, respectively. This difference was statistically significant (P = .04). Comparisons of preoperative and postoperative Voice Handicap Index, acoustic and aerodynamic measures, postoperative breathing ability, subjective comparison of preoperative and postoperative voice, speech intensity, and functional outcome swallowing scale were not statistically significantly different between both groups.
Endoscopic total and partial arytenoidectomy are very successful static surgical options for BVFP. Partial takes longer than total arytenoidectomy. They both provide a comfortable airway, acceptable voice, and acceptable deglutition. It may be a sound practice to perform partial arytenoidectomy initially for primary BVFP cases and reserve total arytenoidectomy for revision cases.
clinicaltrials.gov Identifier: NCT01824849.
全杓状软骨切除术据称会增加误吸风险，导致双侧外展性声带麻痹（BVFP）患者比接受其他手术的患者声音损失更大。然而，缺乏支持这一结论的客观证据。目前尚无研究比较全切除术和部分切除术对吞咽和声音的影响。
比较 BVFP 内镜下全切除术和部分切除术的嗓音和吞咽参数。
设计、地点和参与者：在这项在一家三级转诊大学进行的前瞻性、随机、双盲、病例对照研究中，研究人群包括 20 名 BVFP 患者。
内镜下全切除术和部分切除术。
拔管、手术持续时间、嗓音障碍指数、声学和空气动力学分析、术后呼吸能力、术前和术后嗓音的主观比较、语音强度和功能性吞咽量表。
部分和全杓状软骨切除术的中位手术时间分别为 59 分钟和 49 分钟，差异具有统计学意义（P=0.04）。两组间术前和术后嗓音障碍指数、声学和空气动力学测量、术后呼吸能力、术前和术后嗓音的主观比较、语音强度和功能性吞咽量表的比较均无统计学差异。
对于 BVFP，内镜下全切除术和部分切除术都是非常成功的静态手术选择。部分切除术比全切除术耗时更长。两种术式都能提供舒适的气道、可接受的嗓音和可接受的吞咽功能。对于初次发生的原发性 BVFP 病例，施行部分杓状软骨切除术，将全杓状软骨切除术保留作为翻修术式，可能是一种合理的做法。
clinicaltrials.gov 标识符：NCT01824849。
