Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Laryngoscope. 2020 Jan;130(1):139-145. doi: 10.1002/lary.27868. Epub 2019 Feb 13.
OBJECTIVES/HYPOTHESIS: Wide variation in postinjury functional recovery is a hallmark of unilateral vocal fold paralysis (UVFP), ranging from zero to full recovery. The present study examined the impact of cricothyroid (CT) muscle involvement on recovery using quantitative laryngeal electromyography (LEMG) of the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex at multiple times postinjury.
Prospective cohort study in a medical center.
Eighty-one patients with UVFP (37 males and 44 females) received an initial assessment of quantitative LEMG, stroboscope, acoustic voice analysis and 36-Item Short Form Survey quality-of-life questionnaire at 3 to 6 months after UVFP onset and a follow-up assessment at 12 months after UVFP onset.
The initial and follow-up assessments were performed at 4.3 ± 1.9 and 12.5 ± 1.3 months after UVFP onset, respectively. The peak turn frequency of the TA-LCA muscle complex on the lesion side was improved at the follow-up (470 ± 294 Hz) compared with the initial assessment (300 ± 204 Hz) (P < .001). Patients were also divided into two groups with (n = 27) and without (n = 54) CT involvement, respectively. TA-LCA muscle complex turn frequency improved in patients without CT involvement (from 277 ± 198 to 511 ± 301 Hz; P < .001), but not in those with CT involvement (from 345 ± 211 to 386 ± 265 Hz; P = .46). Seventy-one of all patients received early intervention with intracordal hyaluronate injection, showing similar therapeutic effects in those with and without CT involvement.
Acute UVFP with combined TA-LCA muscle complex and CT muscle involvement has a poor prognosis, with poorer recovery of TA-LCA muscle complex recruitment. Early interventions should be considered in patients with UVFP with CT involvement.
2 Laryngoscope, 130:139-145, 2020.
目的/假设：单侧声带麻痹（UVFP）患者的伤后功能恢复差异很大，从完全恢复到零恢复都有。本研究通过多次伤后即刻定量喉肌电图（LEMG）检测杓状软骨-甲状肌（CT）肌参与情况，探讨其对恢复的影响。
医疗中心的前瞻性队列研究。
81 例单侧声带麻痹患者（37 名男性和 44 名女性）在单侧声带麻痹发病后 3 至 6 个月进行了定量 LEMG、频闪喉镜、声学语音分析和 36 项简明健康调查问卷（SF-36）生活质量问卷的初步评估，并在单侧声带麻痹发病后 12 个月进行了随访评估。
初步评估和随访评估分别在单侧声带麻痹发病后 4.3±1.9 个月和 12.5±1.3 个月进行。患侧杓状软骨-甲杓肌复合体的峰值扭转频率在随访时（470±294Hz）较初始评估时（300±204Hz）提高（P<.001）。患者还分别分为 CT 受累组（n=27）和无 CT 受累组（n=54）。无 CT 受累的患者，杓状软骨-甲杓肌复合体的扭转频率增加（从 277±198 到 511±301Hz；P<.001），但 CT 受累的患者扭转频率没有增加（从 345±211 到 386±265Hz；P=.46）。所有患者中有 71 例接受了早期透明质酸注射声带内注射治疗，CT 受累和无 CT 受累患者的治疗效果相似。
急性单侧声带麻痹伴杓状软骨-甲杓肌复合体和 CT 肌同时受累患者的预后较差，杓状软骨-甲杓肌复合体募集恢复较差。CT 受累的单侧声带麻痹患者应考虑早期干预。
2 级喉镜，130:139-145，2020。
