Karle William E, Helman Samuel N, Cooper Amy, Zhang Yuan, Pitman Michael J
1 Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
2 The Voice and Swallowing Institute, Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York, USA.
Ann Otol Rhinol Laryngol. 2018 Apr;127(4):223-228. doi: 10.1177/0003489417753224. Epub 2018 Jan 17.
Sulcus vocalis and vocal fold scar involve derangement of the superficial lamina propria of the vocal fold, which results in significant dysphonia. Many options exist for treatment, most of which have unsatisfactory and unpredictable outcomes. Autologous transplantation of temporalis fascia into the vocal fold (ATFV) has the potential to be a better treatment option, but long-term outcomes have not been well studied.
Retrospective chart review and patient survey. Twenty-one patients diagnosed with vocal fold scar or sulcus vocalis and treated with ATFV with at least 1-year follow-up were included. Voice Handicap Index 10 (VHI-10) questionnaires were collected preoperatively and 6 months postoperatively. Patients were reached at the time of the study to complete another VHI-10 and a Likert scale survey.
The mean decrease in VHI-10 scores between preoperation and 6 months postoperation was 8.35 ( P < .001). From preoperation to the time of the study (average 44 months; range, 12-72 months), the VHI decreased 13.53 ( P < .001). Eighty-eight percent of patients reported they would recommend this surgery to others with the same diagnosis. Only 1 minor self-limited complication occurred.
Autologous transplantation of temporalis fascia into the vocal fold for the treatment of vocal fold scar and sulcus vocalis is a safe surgery with good long-term outcomes and high patient satisfaction.
声带沟和声带瘢痕涉及声带浅层固有层紊乱,导致严重的发声困难。治疗方法有多种,其中大多数效果不尽人意且不可预测。颞肌筋膜自体移植至声带(ATFV)有可能成为更好的治疗选择,但长期疗效尚未得到充分研究。
回顾性病历审查和患者调查。纳入21例诊断为声带瘢痕或声带沟并接受ATFV治疗且至少随访1年的患者。术前及术后6个月收集嗓音障碍指数10(VHI-10)问卷。在研究期间联系患者以完成另一份VHI-10和李克特量表调查。
术前至术后6个月VHI-10评分的平均下降为8.35(P <.001)。从术前到研究时(平均44个月;范围12 - 72个月),VHI下降了13.53(P <.001)。88%的患者表示会向其他患有相同疾病的人推荐这种手术。仅发生1例轻微的自限性并发症。
颞肌筋膜自体移植至声带治疗声带瘢痕和声带沟是一种安全的手术,具有良好的长期疗效和较高的患者满意度。