Chang Joseph, Schneider Sarah L, Curtis James, Langenstein Jonelyn, Courey Mark S, Yung Katherine C
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California.
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, U.S.A.
Laryngoscope. 2017 Nov;127(11):2591-2595. doi: 10.1002/lary.26773. Epub 2017 Jul 12.
OBJECTIVES/HYPOTHESIS: To evaluate the effect of medialization laryngoplasty (ML) performed alone compared to ML with arytenoid adduction (AA) on glottic gap and voice quality in unilateral vocal fold paralysis (UVFP) patients.
Retrospective case series.
UVFP patients treated with ML alone and ML with AA at the University of California San Francisco Voice and Swallowing Center were identified. Demographic information and history of laryngeal procedures were collected. Preoperative and postoperative examinations were digitally analyzed using ImageJ for normalized anterior and posterior glottic gap and voice samples graded with CAPE-V scores.
Forty-seven patients underwent ML and 27 patients underwent ML with AA. Normalized anterior gap (AG) improved in both ML (preop: 4.4 pixel units (u), postop: 0.8 u; P < 0.001) and ML with AA groups (preop: 3.3 u, postop 0.6 u; P < 0.001). There was no statistically significant difference in normalized AG values between treatment groups. Postoperative normalized posterior gap (PG) improved in the ML with AA group only (preop: 1.8 u, postop: 0.5 u; P = 0.01). Overall severity, roughness, and strain voice parameters had acceptable reliability for analysis. Overall severity improved in ML (preop: 54, postop: 27; P < 0.001) and ML with AA (preop: 44, postop: 24; P = 0.005). There was no statistically significant difference in any voice parameter between treatment groups.
UVFP patients undergoing ML may benefit from addition of AA when a large posterior glottic gap is present. In this study, ML with AA but not ML alone resulted in statistically significant improvement in PG.
目的/假设：评估单纯行喉内移术（ML）与联合杓状软骨内收术（AA）的喉内移术对单侧声带麻痹（UVFP）患者声门间隙和嗓音质量的影响。
回顾性病例系列研究。
确定在加利福尼亚大学旧金山分校嗓音与吞咽中心接受单纯ML治疗以及联合AA的ML治疗的UVFP患者。收集人口统计学信息和喉部手术史。术前和术后检查通过ImageJ进行数字分析，以得出标准化的声门前间隙和后间隙，并根据CAPE-V评分对嗓音样本进行分级。
47例患者接受了ML治疗，27例患者接受了联合AA的ML治疗。单纯ML组（术前：4.4像素单位（u），术后：0.8 u；P < 0.001）和联合AA的ML组（术前：3.3 u，术后0.6 u；P < 0.001）的标准化前间隙（AG）均有所改善。治疗组之间标准化AG值无统计学显著差异。仅联合AA的ML组术后标准化后间隙（PG）有所改善（术前：1.8 u，术后：0.5 u；P = 0.01）。总体严重程度、粗糙度和紧张度嗓音参数具有可接受的分析可靠性。单纯ML组（术前：54，术后：27；P < 0.001）和联合AA的ML组（术前：44，术后：24；P = 0.005）的总体严重程度均有所改善。治疗组之间任何嗓音参数均无统计学显著差异。
存在较大声门后间隙时，接受ML治疗的UVFP患者可能会从联合AA治疗中获益。在本研究中，联合AA的ML而非单纯ML导致PG有统计学显著改善。
4。《喉镜》，127:2591 - 2595，2017年。
