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内镜下后索切开术治疗双侧声带麻痹的疗效

[Therapeutic effects of endoscopic posterior cordotomy for bilateral vocal cord paralysis].

作者信息

Zhao J, Li J R, Guo H G, Wang J S

机构信息

The Sixth Medical Center of Chinese People's Liberation Army General Hospital, College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100048, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Nov 7;55(11):1022-1026. doi: 10.3760/cma.j.cn115330-20200603-00469.

Abstract

To evaluate the efficacy of the endoscopic bilateral posterior transverse partial cordotomy in patients with upper airway obstruction due to bilateral vocal fold paralysis. A retrospective analysis of 48 cases of upper airway obstruction due to bilateral vocal fold paralysis, who were admitted to Department of Otolaryngology Head and Neck Surgery, the Sixth Medical Center of Chinese PLA General Hospital from July 2009 to July 2019, was performed, including 13 males and 35 females. Patients' ages ranged from 27 to 83 years old. All patients underwent bilateral vocal fold posterior resection. Among the 48 patients, 1 patient was lost to follow-up, and the remaining 47 patients were followed up for 5 months to 10 years . None of the 47 patients had a recurrence or severe complications. 89.58% (43/48) patients reconstructed a reliable and effective airway and 88.89% (40/45) patients were decannulated in 1-3 months postoperatively, with the median decannulation time of 1 month. Recovery rate of swallowing function and satisfactory pronunciation were 97.92% (47/48) and 95.35% (41/43) respectively. Endoscopic bilateral posterior transverse partial cordotomy can establish a reliable and effective airway and maximize the protection of swallowing and voice functions. At the same time, it is a safe, reliable, simple and minimally invasive treatment option.

摘要

评估内镜下双侧后横断部分声带切除术治疗双侧声带麻痹所致上气道梗阻患者的疗效。对2009年7月至2019年7月在中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科住院的48例双侧声带麻痹所致上气道梗阻患者进行回顾性分析,其中男性13例,女性35例。患者年龄27至83岁。所有患者均接受双侧声带后部切除术。48例患者中,1例失访,其余47例患者随访5个月至10年。47例患者均无复发或严重并发症。89.58%(43/48)的患者重建了可靠有效的气道,88.89%(40/45)的患者在术后1至3个月拔管,拔管中位时间为1个月。吞咽功能恢复率和发音满意度分别为97.92%(47/48)和95.35%(41/43)。内镜下双侧后横断部分声带切除术可建立可靠有效的气道,并最大程度地保护吞咽和语音功能。同时,它是一种安全、可靠、简单且微创的治疗选择。

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