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注射喉成形术作为单侧声带麻痹患者基于门诊的微创手术——嗓音质量结果

Injection laryngoplasty as miniinvasive office-based surgery in patients with unilateral vocal fold paralysis - voice quality outcomes.

作者信息

Sielska-Badurek Ewelina M, Sobol Maria, Jędra Katarzyna, Rzepakowska Anna, Osuch-Wójcikiewicz Ewa, Niemczyk Kazimierz

机构信息

Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland.

Department of Biophysics and Human Physiology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2017 Sep;12(3):277-284. doi: 10.5114/wiitm.2017.68868. Epub 2017 Jul 17.

Abstract

INTRODUCTION

Injection laryngoplasty (glottis augmentation) is the preferred method in surgical management of unilateral vocal fold paralysis (UVFP). Traditionally, these procedures are performed in the operating room. Nowadays, however, these procedures have moved into the office.

AIM

To evaluate the voice quality after transoral injection laryngoplasty under local anaesthesia in patients with unilateral vocal fold paralysis.

MATERIAL AND METHODS

Fourteen subjects (5 women and 9 men) with unilateral vocal fold paresis (9 with right vocal fold paresis and 5 with left vocal fold paresis) were included in the study. The mean age of the group was 57.8 ±19.0 years (32-83 years). All of the injection laryngoplasties were performed transorally, under local anaesthesia. The injection material was calcium hydroxylapatite. Before and 1, 3 and 6 months after the procedure the following variables were evaluated: voice perception, videostroboscopy, acoustic analysis, aerodynamic evaluation, and the subjective rating of the voice quality by the patient.

RESULTS

After injection laryngoplasty, complete glottal closure was achieved or there was a significant improvement in the glottal closure of each subject. We noted great improvement in the post-injection objective and subjective voice outcomes and patients reported improvement in the voice-related quality of life.

CONCLUSIONS

The transoral approach for injection laryngoplasty under local anaesthesia is an effective and safe way to treat incomplete glottal closure in patients with UVFP. The transoral approach is an efficient alternative to other surgical techniques used for vocal fold injection.

摘要

引言

注射喉成形术(声门扩大术)是单侧声带麻痹(UVFP)外科治疗的首选方法。传统上,这些手术在手术室进行。然而,如今这些手术已可在门诊进行。

目的

评估局部麻醉下经口注射喉成形术治疗单侧声带麻痹患者后的嗓音质量。

材料与方法

本研究纳入了14名单侧声带轻瘫患者(5名女性和9名男性)(9例右侧声带轻瘫,5例左侧声带轻瘫)。该组患者的平均年龄为57.8±19.0岁(32 - 83岁)。所有注射喉成形术均在局部麻醉下经口进行。注射材料为羟基磷灰石钙。在手术前以及术后1、3和6个月,评估以下变量:嗓音感知、频闪喉镜检查、声学分析、空气动力学评估以及患者对嗓音质量的主观评分。

结果

注射喉成形术后,每位受试者均实现了声门完全闭合或声门闭合有显著改善。我们注意到注射后客观和主观嗓音结果均有很大改善,患者报告嗓音相关生活质量有所提高。

结论

局部麻醉下经口注射喉成形术是治疗UVFP患者声门闭合不全的一种有效且安全的方法。经口入路是用于声带注射的其他外科技术的有效替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/feb6/5649502/1005f5de995e/WIITM-12-30279-g001.jpg

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