De Virgilio Armando, Chang Ming-Hong, Jiang Rong-San, Wang Ching-Ping, Wu Shang-Heng, Liu Shih-An, Wang Chen-Chi
Department of Sensory Organs, ENT Section, Sapienza University of Rome, Rome, Italy Department of Otolaryngology, Taichung Veterans General Hospital, Taichung City, Taiwan.
Department of Neurology, Taichung Veterans General Hospital, Taichung City, Taiwan.
Otolaryngol Head Neck Surg. 2014 Dec;151(6):996-1002. doi: 10.1177/0194599814549740. Epub 2014 Sep 11.
Recurrent laryngeal nerve (RLN) injury may induce unilateral vocal fold paralysis (UVFP). During thyroidectomy, the most common cause of UVFP, the superior laryngeal nerve (SLN), is also at risk of injury. In the literature, the influence of SLN injury on glottal configuration and function in patients with UVFP remains controversial. The present study investigates SLN injury influence on glottal configuration and function in patients with UVFP after thyroidectomy.
Prospective controlled study.
Tertiary medical center.
The SLN and RLN function of 34 patients with UVFP after thyroidectomy was determined by laryngeal electromyography. The subjects were dichotomized into the isolated RLN injury group (n = 26) or the concurrent SLN/RLN injury group (n = 8). We evaluated glottal angle and paralyzed vocal fold shape during inspiration, normalized glottal gap area, and glottal shape during phonation. The glottal function measurements included voice acoustic and aerodynamic analyses and the Voice Handicap Index. The aforementioned parameters of the RLN and concurrent SLN/RLN injury groups were compared.
There were no statistical differences in glottal configuration such as glottal angle, paralyzed vocal fold shape, normalized glottal gap area, and glottal shape between the RLN and concurrent SLN/RLN injury groups. There were also no significant differences in other glottal function analyses including fundamental frequency, mean airflow rate, phonation quotient, maximal phonation time, and Voice Handicap Index.
In the present study, we did not find any evidence that SLN injury could significantly influence the glottal configuration and function in patients with UVFP.
喉返神经（RLN）损伤可导致单侧声带麻痹（UVFP）。在甲状腺切除术中，UVFP最常见的原因是喉上神经（SLN）也有受伤风险。在文献中，SLN损伤对UVFP患者声门形态和功能的影响仍存在争议。本研究调查甲状腺切除术后SLN损伤对UVFP患者声门形态和功能的影响。
前瞻性对照研究。
三级医疗中心。
通过喉肌电图测定34例甲状腺切除术后UVFP患者的SLN和RLN功能。将受试者分为单纯RLN损伤组（n = 26）或同时存在SLN/RLN损伤组（n = 8）。我们评估了吸气时的声门角度和麻痹声带形状、标准化声门间隙面积以及发声时的声门形状。声门功能测量包括语音声学和空气动力学分析以及嗓音障碍指数。比较RLN损伤组和同时存在SLN/RLN损伤组的上述参数。
RLN损伤组和同时存在SLN/RLN损伤组在声门形态方面，如声门角度、麻痹声带形状、标准化声门间隙面积和声门形状，没有统计学差异。在其他声门功能分析中，包括基频、平均气流量、发声商、最大发声时间和嗓音障碍指数，也没有显著差异。
在本研究中，我们没有发现任何证据表明SLN损伤会显著影响UVFP患者的声门形态和功能。
