Verma Sunil P, Dailey Seth H
University Voice and Swallowing Center, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine School of Medicine, California.
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
J Voice. 2014 May;28(3):382-6. doi: 10.1016/j.jvoice.2013.10.006. Epub 2014 Feb 1.
Office-based injection laryngoplasty (OBIL) is a common method of addressing glottal insufficiency. This retrospective chart review identifies the demongraphics, laterality, technique, success rate, injectates, and complications of OBIL performed over a 3-year period at a single institution.
Retrospective chart review.
All OBILs performed for the management of UVFP by the senior author over 3 years (2007-2009) were identified from billing records. The age, gender, laterality, underlying disease process, augmentation material, route of injection, and complications were recorded.
Eighty-two OBILs were attempted on 57 patients. The most common route of access was transoral (85.6%). All OBILs were able to be completed. Injectates used were hyaluronic acid derivatives (57.3%), calcium hydroxyapatite (16%), and Cymmetra (16.5%). Three complications (3.7%) occurred. Thirty percent of patients ultimately elected for thyroplasty or ansa reinnervation, 22% found their condition to self-resolve, 14% died, and 25% were lost to follow-up.
Using a variety of approaches, OBIL is possible in almost all patients. The single surgeon transoral route using a rigid angled telescope and curved injection needle was the most commonly used approach. Multiple injectates can be used and have good safety records. The final disposition of patients may be variable and warrants further investigation.
门诊注射喉成形术（OBIL）是治疗声门闭合不全的常用方法。本回顾性病历审查确定了在单一机构进行的为期3年的OBIL的人口统计学特征、患侧、技术、成功率、注射材料及并发症。
回顾性病历审查。
从计费记录中识别出资深作者在3年（2007 - 2009年）期间为治疗单侧声带麻痹而进行的所有OBIL。记录患者的年龄、性别、患侧、潜在疾病过程、填充材料、注射途径及并发症。
对57例患者进行了82次OBIL尝试。最常见的进入途径是经口（85.6%）。所有OBIL均得以完成。使用的注射材料有透明质酸衍生物（57.3%）、羟基磷灰石钙（16%）和Cymmetra（16.5%）。发生了3例并发症（3.7%）。30%的患者最终选择了甲状成形术或喉返神经袢植入术，22%的患者病情自行缓解，14%的患者死亡，25%的患者失访。
采用多种方法，几乎所有患者都可行OBIL。单一外科医生经口途径使用硬性角形望远镜和弯曲注射针是最常用的方法。可使用多种注射材料，且安全性良好。患者的最终转归可能各不相同，值得进一步研究。
