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自体脂肪移植在单侧声带麻痹治疗中的应用——单中心 15 年经验。

Autologous Fat Augmentation in the Treatment of Unilateral Vocal Fold Paralysis - A 15-year Experience in a Single Institution.

机构信息

1ENT Department, University Hospital Centre Zagreb, Zagreb, Croatia, 2Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Croatia, 3School of Medicine, Zagreb University, Croatia, 4Faculty of Education and Rehabilitation Sciences, Zagreb University, Croatia.

出版信息

Acta Clin Croat. 2020 Jun;59(Suppl 1):32-37. doi: 10.20471/acc.2020.59.s1.04.

DOI:10.20471/acc.2020.59.s1.04
PMID:34219882
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8212613/
Abstract

Autologous fat vocal fold augmentation is a widespread surgical procedure that aims to repair glottal incompetence in patients with unilateral vocal fold paralysis (UVFP). However, there are some concerns in the literature about the long-term results of this technique. At the ENT Department of the Zagreb University Hospital Centre, this technique has been in use for more than 15 years, and a retrospective medical chart review was conducted from June 2005 to November 2019. Overall, 78 patients with UVFP met the inclusion criteria for enrolment in the study. All patients underwent at least one preoperative and two postoperative voice assessments, one early (within 3 months from surgery) and one late (at least 1 year after surgery). All tested voice outcome parameters (maximum phonation time (MPT), jitter, shimmer, noise-to-harmonic ratio (NHR)) significantly improved after surgery, both early and late postoperatively (p<0.001). The reoperation rate was only 10.3% (8/78), with the majority of patients in our series experiencing long-term benefits from this surgical procedure. According to the results of our study, autologous fat vocal fold augmentation appears to be a highly useful and effective surgical technique with long-lasting results in the majority of patients suffering from UVFP.

摘要

自体脂肪声带增强术是一种广泛应用的手术方法,旨在修复单侧声带麻痹(UVFP)患者的声门关闭不全。然而,文献中存在一些关于该技术长期效果的担忧。在萨格勒布大学医院中心的耳鼻喉科,这项技术已经使用了 15 年以上,我们对 2005 年 6 月至 2019 年 11 月期间的病历进行了回顾性分析。共有 78 名单侧声带麻痹患者符合纳入研究的标准。所有患者均至少进行了一次术前和两次术后的嗓音评估,一次早期(术后 3 个月内)和一次晚期(术后至少 1 年)。所有测试的嗓音结果参数(最长发声时间(MPT)、抖动、声颤、噪声与谐噪比(NHR))在术后均明显改善,无论是早期还是晚期(p<0.001)。再次手术率仅为 10.3%(8/78),我们的研究中大多数患者长期受益于这种手术。根据我们的研究结果,自体脂肪声带增强术似乎是一种非常有用和有效的手术技术,对大多数单侧声带麻痹患者具有持久的效果。

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本文引用的文献

1
The surgical treatment of unilateral vocal cord paralysis (UVCP): qualitative review analysis and meta-analysis study.单侧声带麻痹(UVCP)的手术治疗:定性回顾分析和荟萃分析研究。
Eur Arch Otorhinolaryngol. 2019 Oct;276(10):2649-2659. doi: 10.1007/s00405-019-05587-2. Epub 2019 Aug 2.
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Perspectives on voice treatment for unilateral vocal fold paralysis.单侧声带麻痹的嗓音治疗观点
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Voice outcome indicators for unilateral vocal fold paralysis surgery: a review of the literature.
单侧声带麻痹手术的嗓音结果指标:文献回顾。
Eur Arch Otorhinolaryngol. 2018 Feb;275(2):459-468. doi: 10.1007/s00405-017-4844-9. Epub 2017 Dec 20.
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Eur Arch Otorhinolaryngol. 2017 Jan;274(1):347-353. doi: 10.1007/s00405-016-4225-9. Epub 2016 Jul 25.
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Augmentation Autologous Adipose Injections in the Larynx.喉部自体脂肪注射填充
Ann Otol Rhinol Laryngol. 2016 Jan;125(1):25-30. doi: 10.1177/0003489415595427. Epub 2015 Jul 19.
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[Locally invasive papillary thyroid cancer--our experience].[局部侵袭性甲状腺乳头状癌——我们的经验]
Lijec Vjesn. 2012 Sep-Oct;134(9-10):266-70.
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Single institutional analysis of trends over 45 years in etiology of vocal fold paralysis.单机构对45年来声带麻痹病因趋势的分析。
Auris Nasus Larynx. 2012 Dec;39(6):597-600. doi: 10.1016/j.anl.2012.02.001. Epub 2012 Mar 6.
8
Laryngeal complications after lipoinjection for vocal fold augmentation.用于声带增厚的脂肪注射后的喉部并发症。
Laryngoscope. 2009 Aug;119(8):1652-7. doi: 10.1002/lary.20529.
9
A prospective observational study of 363 cases operated with three different harmonic scalpels.一项前瞻性观察研究,纳入 363 例使用三种不同超声刀头进行手术的病例。
Eur Arch Otorhinolaryngol. 2009 Dec;266(12):1965-70. doi: 10.1007/s00405-009-0954-3. Epub 2009 Mar 24.
10
Autogenous fat injection for glottic insufficiency: analysis of 101 cases and correlation with patients' self-assessment.自体脂肪注射治疗声门闭合不全:101例分析及与患者自我评估的相关性
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