Tucker H M
Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, OH 44195.
Ann Otol Rhinol Laryngol. 1989 Jan;98(1 Pt 1):52-4. doi: 10.1177/000348948909800111.
Spasmodic dysphonia continues to be a management problem for otolaryngologists. Selective lysis of the recurrent laryngeal nerve has been useful in the management of this disease. Reported long-term results, however, reveal that spasm recurs in approximately 40% to 50% of initially successful patients in spite of persistence of the unilateral vocal fold paralysis. Although some of these failure can be recaptured with subsequent laser surgery, the overall "cure" rate does not exceed 70%, even in the best hands. The contributions of Isshiki, LeJeune, and Tucker have demonstrated that tension in the vocal folds can be adjusted by laryngeal framework surgery. Experience with 16 patients suffering from adductor spasmodic dysphonia suggests that laryngeal framework surgery is useful in the management of this disorder.
痉挛性发声障碍仍然是耳鼻喉科医生面临的一个治疗难题。选择性喉返神经松解术在该疾病的治疗中已被证明是有效的。然而，长期报告结果显示，尽管单侧声带麻痹持续存在，但约40%至50%最初治疗成功的患者仍会复发痉挛。尽管随后的激光手术可以挽救其中一些失败病例，但即使是最有经验的医生，总体“治愈率”也不超过70%。石木、勒热内和塔克的研究表明，通过喉框架手术可以调整声带的张力。对16例内收型痉挛性发声障碍患者的治疗经验表明，喉框架手术在该疾病的治疗中是有效的。
