Chen Renhui, Wu Minjian, Yang Jinshan, Chen Wenjun, Liang Faya
Department of Otolaryngology Head and Neck Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510120,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Oct;36(10):776-780. doi: 10.13201/j.issn.2096-7993.2022.10.010.
To investigate the strobovideolaryngoscopy, acoustic and aerodynamic characteristics of transient unilateral vocal ford paralysis(UVFP) after thyroidectomy. A retrospective analysis was made of 11 patients with temporary UVFP after thyroidectomy who were treated in Department of Otolaryngology and Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University from January 2013 to March 2021; 8 patients with permanent UVFP after thyroidectomy during the same period were included as a control group. The differences in baseline strobovideolaryngoscopy, acoustic and aerodynamic measures were compared between the two groups. The tones of patients with temporary UVFP after thyroidectomy were all normal, and the proportions of abnormal vocal fords(vocal ford bowing, atrophy, and shortening), ventricular adduction and glottic insufficiency were significantly lower than those of permanent UVFP patients; arytenoid cartilage stability and height mismatch of vocal ford tended to be better than permanent UVFP. The maximal phonation time(MPT) in patients with temporary UVFP was (8.5±4.1) s, which was significantly longer than (3.9±2.1) s in patients with permanent UVFP; fundamental frequency, mean airflow(MeAF) and mean subglottic pressure(SGP) were better in temporary UVFP than those in patients with permanent UVFP, but the difference did not reach statistical significance. None and mild glottic insufficiency, normal tone, ventricular adduction, and vocal ford appearances without vocal fold bowing, atrophy, and shortening, can be served as the predictors for the early recovery of vocal ford movement in temporary UVFP after thyroidectomy. The MPT less than 4 s, and MeAF, and SGP remarkably increased is the predictor of poor prognosis for vocal ford recovery.
探讨甲状腺切除术后一过性单侧声带麻痹(UVFP)的频闪喉镜、声学及空气动力学特征。回顾性分析2013年1月至2021年3月在中山大学孙逸仙纪念医院耳鼻咽喉头颈外科治疗的11例甲状腺切除术后发生暂时性UVFP的患者;同期8例甲状腺切除术后发生永久性UVFP的患者作为对照组。比较两组患者基线频闪喉镜、声学及空气动力学指标的差异。甲状腺切除术后暂时性UVFP患者的音调均正常,声带异常(声带弓化、萎缩及缩短)、室带内收及声门闭合不全的比例显著低于永久性UVFP患者;杓状软骨稳定性及声带高度不匹配情况倾向于优于永久性UVFP患者。暂时性UVFP患者的最大发声时间(MPT)为(8.5±4.1)秒,显著长于永久性UVFP患者的(3.9±2.1)秒;暂时性UVFP患者的基频、平均气流量(MeAF)及平均声门下压力(SGP)均优于永久性UVFP患者,但差异未达到统计学意义。无或轻度声门闭合不全、音调正常、室带内收以及无声带弓化、萎缩及缩短的声带外观,可作为甲状腺切除术后暂时性UVFP患者声带运动早期恢复的预测指标。MPT小于4秒,以及MeAF和SGP显著升高是声带恢复预后不良的预测指标。