Matievics Vera, Sztanó Balázs, Bach Ádám, Rovó László
Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Tisza L. krt. 111., 6725.
Orv Hetil. 2018 Jul;159(29):1188-1192. doi: 10.1556/650.2018.31099.
Dyspnea caused by bilateral vocal cord paralysis often requires surgical intervention to prevent acute asphyxiation. The regeneration of the laryngeal nerves may last weeks or months and it is difficult to predict the outcome. In the past decades, several open and endoscopic surgical techniques have been introduced for treatment to avoid tracheostomy, however, these procedures with resection of the glottis resulted in irreversible changes in the laryngeal structure, thus the voice quality decreased over a long-term period.
Endoscopic arytenoid abduction lateropexy is an accepted reversible, minimally invasive technique that provides an immediate patent airway by the lateralisation of the arytenoid cartilage with a suture. The aim of our study was to analyze the phonatory and respiratory outcomes of this treatment concept.
Two patients suffering from bilateral vocal cord palsy were treated with endoscopic arytenoid abduction lateropexy. After recovery of the vocal cord movements, the sutures were removed. Spirometric and phoniatric results of the two patients were analysed after suture removal.
Good spirometric parameters and normal voice quality were detected in both cases.
These results prove the high reversibility of the minimally invasive endoscopic arytenoid abduction lateropexy. Lateralization suture can be removed in the case of vocal cord movement recovery, and phonation may be physiological. Orv Hetil. 2018; 159(29): 1188-1192.
双侧声带麻痹引起的呼吸困难通常需要手术干预以预防急性窒息。喉神经的再生可能持续数周或数月，且难以预测结果。在过去几十年中，已引入多种开放和内镜手术技术用于治疗以避免气管切开术，然而，这些切除声门的手术导致喉部结构发生不可逆变化，因此长期来看嗓音质量下降。
内镜下杓状软骨外展固定术是一种公认的可逆、微创技术，通过用缝线使杓状软骨侧移来立即提供通畅气道。我们研究的目的是分析这种治疗理念的发声和呼吸效果。
两名双侧声带麻痹患者接受了内镜下杓状软骨外展固定术治疗。声带运动恢复后，拆除缝线。拆除缝线后分析了这两名患者的肺功能和发声结果。
两例患者均检测到良好的肺功能参数和正常的嗓音质量。
这些结果证明了微创内镜下杓状软骨外展固定术具有高度可逆性。声带运动恢复时可拆除侧移缝线，发声可能恢复正常。《匈牙利医学周报》2018年；159(29):1188 - 1192。
