Gotxi-Erezuma Itziar, Ortega-Galán Mónica, Laso-Elguezabal Ainhoa, Prieto Puga Gonzalo, Bullido-Alonso Carolina, García-Gutiérrez Susana, Anton-Ladislao Ane, Moreno-Alonso Enrique
Servicio de Otorrinolaringología, Hospital Galdakao-Usansolo, Vizcaya, España.
Servicio de Neurofisiología Clínica, Hospital Galdakao-Usansolo, Vizcaya, España.
Acta Otorrinolaringol Esp (Engl Ed). 2017 Sep-Oct;68(5):274-283. doi: 10.1016/j.otorri.2016.12.001. Epub 2017 Feb 24.
To assess the effectiveness of electromyography-guided hyaluronic acid injection laryngoplasty in the early stage of unilateral vocal fold paralysis in terms of patient recovery from dysphonia and quality of life.
Between January and December 2014, 28 patients with unilateral vocal fold paralysis underwent electromyography and injection of hyaluronic acid in the thyroarytenoid muscle. We compared the voice handicap index, grade, roughness, breathiness, asthenia, strain scale (GRBAS), videostroboscopic parameters and maximum phonation time assessed before, 15 days and 6 months after the intervention, using the non-parametric Wilcoxon rank test.
Out of the 28 patients, 1 had a haematoma in the injected vocal fold (3.57%) and 6 required second injections. The maximum phonation time of the vowel /e/ increased from 6.07 to 12.14 sec. (15 days post-intervention) and subsequently 12.75 (6 months post-intervention). There was also a significant improvement in the grade, roughness, breathiness, asthenia, strain scale in parameters G, B and A both 15 days and 6 months after the intervention. The voice handicap index score decreased from 58.29 to 37.63 (15 days post-intervention) and 29.64 (6 months post-intervention).
Electromyography-guided hyaluronic injection laryngoplasty in unilateral vocal fold paralysis enables, in the same intervention, neuromuscular assessment and temporary treatment of glottic insufficiency with a low risk of complications and improvement in patient's quality of life. This may reduce the need for subsequent treatments, but further research is required to confirm these findings.
评估肌电图引导下透明质酸注射喉成形术对单侧声带麻痹早期患者嗓音障碍恢复及生活质量的有效性。
2014年1月至12月期间，28例单侧声带麻痹患者接受了肌电图检查并在甲杓肌内注射透明质酸。我们使用非参数Wilcoxon秩和检验比较了干预前、干预后15天和6个月时评估的嗓音障碍指数、等级、粗糙度、气息声、无力感、紧张度量表（GRBAS）、频闪喉镜参数和最长发声时间。
28例患者中，1例注射侧声带出现血肿（3.57%），6例需要二次注射。元音/e/的最长发声时间从6.07秒增加到12.14秒（干预后15天），随后为12.75秒（干预后6个月）。干预后15天和6个月时，参数G、B和A的等级、粗糙度、气息声、无力感、紧张度量表也有显著改善。嗓音障碍指数评分从58.29降至37.63（干预后15天）和29.64（干预后6个月）。
肌电图引导下透明质酸注射喉成形术用于单侧声带麻痹，在同一干预中能够进行神经肌肉评估并临时治疗声门闭合不全，并发症风险低且能改善患者生活质量。这可能减少后续治疗的需求，但需要进一步研究来证实这些发现。
