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双侧声带麻痹患者行“缝扎杓状软骨外侧固定术”后的声门气道增益

Glottic airway gain after 'suture arytenoid laterofixation' in bilateral vocal cord paralysis.

作者信息

Korkmaz Mehmet Hakan, Bayır Ömer, Tatar Emel Çadallı, Saylam Güleser, Öcal Bülent, Keseroğlu Kemal, Özdek Ali

机构信息

Department of Otolaryngology and Head & Neck Surgery, Medical Faculty, Yıldırım Beyazıt University , Ankara , Turkey.

出版信息

Acta Otolaryngol. 2015 Sep;135(9):931-6. doi: 10.3109/00016489.2015.1042554. Epub 2015 Apr 30.

Abstract

CONCLUSION

This method is an easy, non-expensive, and effective technique in bilateral vocal cord paralysis to improve glottic airway and clinical performance.

OBJECTIVE

To evaluate the effectiveness of 'suture arytenoid laterofixation' surgery in bilateral vocal cord paralysis.

MATERIALS AND METHODS

A retrospective analysis of patients' medical history undergoing 'suture arytenoid laterofixation' surgery for bilateral vocal cord paralysis. This technique was applied under general anesthesia with both microlaryngoscopy and video-monitoring. Two 16 g needles and one 1/0 nylon thread were used for the procedure with 1 cm skin incision; no tracheotomy or tissue excision was required. Pre-post-operative photographs of the glottic region were taken from the endoscopic records, and the areas of rima glottis openings were calculated with the Image-J programme.

RESULTS

Forty-seven patients were analyzed. The mean pre-post-operative rima glottis areas were 1.11 ± 0.56 and 2.24 ± 0.93 mm(2), respectively (p < 0.001). Five patients with previous tracheotomy were decannulated within a few days after the operation. In three patients, mild complications developed in the early post-operative period (two laryngeal edemas, one submucosal hematoma). Tracheotomy was performed to only one pregnant patient in the post-operative first day. None of the patients had granulation formation or synechia.

摘要

结论

该方法是一种用于双侧声带麻痹的简便、经济且有效的技术,可改善声门气道及临床症状。

目的

评估“缝匠肌后固定术”治疗双侧声带麻痹的有效性。

材料与方法

对接受“缝匠肌后固定术”治疗双侧声带麻痹患者的病史进行回顾性分析。该技术在全身麻醉下通过显微喉镜和视频监测应用。手术采用两根16g针头和一根1/0尼龙线,皮肤切口1cm;无需气管切开或组织切除。从内镜记录中获取声门区域的术前和术后照片,并用Image-J程序计算声门裂开口面积。

结果

分析了47例患者。术前和术后声门裂平均面积分别为1.11±0.56和2.24±0.93mm²(p<0.001)。5例曾行气管切开术的患者在术后数天内拔管。3例患者在术后早期出现轻度并发症(2例喉水肿,1例黏膜下血肿)。仅1例孕妇在术后第一天行气管切开术。所有患者均未出现肉芽形成或粘连。

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