Murty G E, Smith M C
Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne.
J Laryngol Otol. 1989 Oct;103(10):968-9. doi: 10.1017/s0022215100110643.
Three cases of left recurrent laryngeal nerve palsy following heart-lung transplantation are described. In each case, within twelve hours of extubation, the left vocal cord was injected with Teflon, and the paralyzed vocal cord thus displaced to the midline. Effective closure of the glottis was then possible, permitting an adequate cough, adequate clearing of the bronchial tree and minimising the risk of aspiration. Augmentation under general anaesthesia as soon as possible after discovery of vocal cord dysfunction is advocated. Suitable materials for injection are discussed. To our knowledge, this is the first reported series of vocal cord augmentation in the acute phase following heart-lung transplantation.
本文描述了3例心肺移植术后出现左侧喉返神经麻痹的病例。在每例患者中，拔管后12小时内，向左侧声带注射聚四氟乙烯，使麻痹的声带移位至中线。这样就可以有效地闭合声门，从而实现充分咳嗽、充分清理支气管树并将误吸风险降至最低。建议在发现声带功能障碍后尽快在全身麻醉下进行扩容治疗。文中讨论了适合注射的材料。据我们所知，这是首次报道的心肺移植术后急性期声带扩容治疗系列病例。
