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自体脂肪颗粒填充联合显微缝合技术治疗声带沟

[Autologous fat granule filling combined with microsuture technique for sulcus vocalis].

作者信息

Cai Mingjing, Sun Zihui, Sun Guoyan, Zhang Qingxiang, He Shuangba

机构信息

Department of Otolaryngology Head and Neck Surgery,Nanjing Tongren Hospital,School of Medicine,Southeast University,Nanjing Tongren ENT Hospital,Nanjing,210002,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 May;35(5):405-409. doi: 10.13201/j.issn.2096-7993.2021.05.005.

Abstract

To explore and observe voice effect of the resection of the vocal fold sulcus, suture of the vocal fold mucosa, and fat granule packing under the support laryngoscope. A total of 25 patients with vocal fold sulcus underwent vocal fold sulcus resection under a support laryngoscope. After the vocal fold sulcus was removed, the mucosa on both sides of the vocal fold sulcus was sutured into a pouch. Next the fat granules removed from the abdomen were stuffed into the pouch until the vocal folds were full, and the mucosa was repaired, and then the pouched mucosa was sutured. After the operation, the patients were silent for 2 weeks and followed up at 3, 6, and 12 months postoperatively to observe the state of the vocal fold mucosa and the voice effect of the vocal fold under the stroboscopic laryngoscopy. The main outcome measures were the mucosal movement, fundamental frequency (F0), fundamental frequency perturbation (Jitter), amplitude perturbation (Shimmer), normalized noise energy (NNE), harmony/noise (H/N) and maximum phonation time (MPT). Results: Among the 25 patients, 23 patients had good vocal fold closure and smooth mucosa. Under the stroboscopic laryngoscope, the mucosal movement was good and smooth, and the F0, Jitter, Shimmer, NNE, H/N, MPT were significantly improved, and the voice quality was significantly improved. The other 2 patients had fat particles spillover in the vocal fold. The voice function recovered well after the second treatment. Resection of vocal fold sulcus, suture of vocal fold mucosa, and fat granule packing under support laryngoscope are very effective for the treatment of vocal fold sulcus. Indispensably, the operation is done properly, and the patient silence the voice according to the doctor's advice, thus the voice quality will be satisfactory after the operation. .

摘要

探讨并观察支撑喉镜下声带沟切除术、声带黏膜缝合术及脂肪颗粒填充术的嗓音效果。选取25例声带沟患者,在支撑喉镜下行声带沟切除术。切除声带沟后,将声带沟两侧黏膜缝合成袋状。然后将取自腹部的脂肪颗粒填入袋内,直至声带饱满,修复黏膜,再缝合袋状黏膜。术后患者禁声2周,分别于术后3、6、12个月进行随访,通过频闪喉镜观察声带黏膜状态及声带嗓音效果。主要观察指标为黏膜运动、基频(F0)、基频微扰(Jitter)、幅度微扰(Shimmer)、归一化噪声能量(NNE)、谐噪比(H/N)及最长发声时间(MPT)。结果:25例患者中,23例声带闭合良好,黏膜光滑。频闪喉镜下黏膜运动良好、顺畅,F0、Jitter、Shimmer、NNE、H/N、MPT均显著改善,嗓音质量明显提高。另外2例患者声带出现脂肪颗粒溢出,二次处理后嗓音功能恢复良好。支撑喉镜下声带沟切除术、声带黏膜缝合术及脂肪颗粒填充术治疗声带沟效果显著。手术操作必须得当,患者需遵医嘱禁声,术后嗓音质量方可满意。

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