Fang Tuan-Jen, Hsin Li-Jen, Chung Hsiu-Feng, Chiang Hui-Chen, Li Hsueh-Yu, Wong Alice M K, Pei Yu-Chen
From the Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei (T-JF, L-JH, H-FC, H-YL); School of Medicine, Chang Gung University, Taoyuan (T-JF, L-JH, H-YL, AMKW, Y-CP); Department of Management, Graduate School, Ming Chung University (H-CC); Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital (AMKW, Y-CP); Healthy Aging Research Center, Chang Gung University (Y-CP); and Center of Biomedical Engineering, Chang Gung University, Taipei, Taiwan, ROC (Y-CP).
Medicine (Baltimore). 2015 Oct;94(40):e1787. doi: 10.1097/MD.0000000000001787.
Thoracic-surgery-related unilateral vocal fold paralysis (UVFP) may cause severe morbidity and can cause profound functional impairment and psychosocial stress in patients with pre-existing thoracic diseases. In-office intracordal hyaluronate (HA) injections have recently been applied to improve voice and quality of life in patients with vocal incompetence, but their effect on thoracic-surgery-related UVFP remains inconclusive. We therefore conducted a prospective study to clarify the effect of early HA injection on voice and quality of life in patients with thoracic-surgery-related UVFP. Patients with UVFP within 3 months after thoracic surgery who received office-based HA injection were recruited. Quantitative laryngeal electromyography, videolaryngostroboscopy, voice-related life quality (voice outcome survey), laboratory voice analysis, and health-related quality of life (SF-36) were evaluated at baseline, and at 1 month postinjection. A total of 104 consecutive patients accepted office-based HA intracordal injection during the study period, 34 of whom were treated in relation to thoracic surgery and were eligible for inclusion. Voice-related life quality, voice laboratory analysis, and most generic quality of life domains were significantly improved at 1 month after in-office HA intracordal injection. No HA-related complications were reported. Single office-based HA intracordal injection is a safe and effective treatment for thoracic-surgery-related UVFP, resulting in immediate improvements in patient quality of life, voice quality, and swallowing ability.
胸外科相关的单侧声带麻痹（UVFP）可能导致严重的发病率，并可能给患有胸科疾病的患者带来严重的功能损害和心理社会压力。门诊声带内透明质酸（HA）注射近来已被用于改善发声功能不全患者的嗓音和生活质量，但其对胸外科相关UVFP的效果仍不明确。因此，我们开展了一项前瞻性研究，以阐明早期HA注射对胸外科相关UVFP患者嗓音和生活质量的影响。招募了在胸外科手术后3个月内发生UVFP且接受门诊HA注射的患者。在基线时以及注射后1个月，对患者进行定量喉肌电图、视频喉镜频闪检查、嗓音相关生活质量（嗓音结果调查）、嗓音实验室分析以及健康相关生活质量（SF-36）评估。在研究期间，共有104例连续患者接受了门诊声带内HA注射，其中34例因胸外科手术相关原因接受治疗且符合纳入标准。门诊声带内HA注射后1个月，嗓音相关生活质量、嗓音实验室分析以及大多数一般生活质量领域均有显著改善。未报告与HA相关的并发症。单次门诊声带内HA注射是治疗胸外科相关UVFP的一种安全有效的方法，可使患者的生活质量、嗓音质量和吞咽能力立即得到改善。
