Department of Otolaryngology, Vanderbilt Bill Wilkerson Center, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
Laryngoscope. 2014 Feb;124(2):481-6. doi: 10.1002/lary.24324. Epub 2013 Oct 2.
OBJECTIVES/HYPOTHESIS: The purpose of this study was to evaluate the return of vibratory function and restoration of vibration amplitude and symmetry after vocal fold microflap surgery.
Prospective in vivo animal model.
Microflap surgery was performed on 30 New Zealand white breeder rabbits. The left vocal fold received a 3-mm epithelial incision and mucosal elevation, while the contralateral vocal fold was left intact to serve as an internal control. Quantitative analysis of amplitude ratio and lateral phase difference were measured using high-speed laryngeal imaging at a frame rate of 10,000 frames per second from animals undergoing evoked phonation on postoperative days 0, 1, 3, 5, and 7.
Quantitative measures revealed a significantly reduced amplitude ratio and lateral phase difference on day 0 after microflap. These impairments of vibratory function on day 0 were associated with separation of the vocal fold's body-cover layer. Amplitude ratio increased significantly by day 3 after microflap, with further increases in vibration amplitude on days 5 and 7. While the amplitude ratio improved significantly on day 3, lateral phase difference decreased significantly on day 3, and returned to normal on days 5 and 7.
High-speed laryngeal imaging was used to investigate the natural time course of postmicroflap recovery of vibratory function. Results revealed the restoration of vibration amplitude and lateral phase difference by days 3 to 7 after microflap. The time period of improved vibratory function observed in this study coincides with the end of the well-documented inflammatory phase of vocal fold wound repair.
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目的/假设：本研究旨在评估声带微瓣手术后振动功能的恢复和振动幅度及对称性的恢复。
前瞻性体内动物模型。
对 30 只新西兰白兔进行微瓣手术。左侧声带接受 3mm 的上皮切口和黏膜抬高，而对侧声带保持完整作为内部对照。在术后第 0、1、3、5 和 7 天，通过诱发发声，以每秒 10000 帧的帧率，使用高速喉镜成像对振幅比和横向相位差进行定量分析。
定量测量显示，微瓣术后第 0 天的振幅比和横向相位差显著降低。这些振动功能的损伤与声带体被层的分离有关。微瓣术后第 3 天振幅比显著增加，第 5 天和第 7 天振动幅度进一步增加。虽然振幅比在第 3 天显著改善，但横向相位差在第 3 天显著降低，并在第 5 天和第 7 天恢复正常。
使用高速喉镜成像研究了微瓣后振动功能恢复的自然时间过程。结果显示，微瓣后第 3 天至第 7 天恢复了振动幅度和横向相位差。本研究观察到的改善振动功能的时间与声带伤口修复的有明确记载的炎症期结束相吻合。
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