Müller A H
Klinik für HNO-Heilkunde/Plastische Operationen, SRH Wald-Klinikum Gera, Straße des Friedens 122, 07548, Gera, Deutschland.
HNO. 2017 Jul;65(7):621-630. doi: 10.1007/s00106-017-0369-1.
Whereas static vocal fold medialization or lateralization are currently the standard procedures, new dynamic treatment methods such as reinnervation and laryngeal pacing focus on better toning and remobilization of the paralyzed vocal folds. End-to-end or jump anastomoses of the recurrent laryngeal nerve can preserve muscle mass and avoid atrophy, thus enabling subsequent dynamic therapeutic options. Prognostic evaluation and the time point of therapeutic intervention are important issues in the management of patients with recurrent laryngeal nerve paralysis. Irreversible interventions should be avoided at early time points or during childhood in order to allow for spontaneous remission and dynamic therapeutic options.
虽然静态声带内收或外展目前是标准手术,但诸如神经再支配和喉起搏等新的动态治疗方法专注于更好地调节和恢复麻痹声带的活动。喉返神经的端端或跳跃吻合可保留肌肉量并避免萎缩,从而为后续的动态治疗选择创造条件。预后评估和治疗干预的时间点是喉返神经麻痹患者管理中的重要问题。在早期或儿童期应避免不可逆的干预,以便实现自发缓解和采用动态治疗选择。