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低温等离子射频消融术治疗成人喉血管瘤

Management of Adult Laryngeal Hemangioma With Low-Temperature Plasma Radiofrequency Coblation.

作者信息

OuYang ZhiGuo, Lou Zhengcai

机构信息

Department of Otolaryngology-Head and Neck Surgery, Yiwu Central Hospital, Yiwu, Zhejiang, China.

出版信息

Ear Nose Throat J. 2023 Jul 3:1455613231185018. doi: 10.1177/01455613231185018.

Abstract

This study investigated the therapeutic effects of low-temperature plasma radiofrequency (LPRF) coblation on adult laryngeal hemangiomas (ALHs) using suspension laryngoscopy. : The clinical data of 23 patients with ALH treated by LPRF coblation were analyzed retrospectively. All patients underwent edge coagulation before ablation resection. Postoperative voice and swallowing were assessed. : The 23 ALHs were diagnosed clinically as 6 cavernous hemangiomas and 17 capillary fibroangiomas. All 23 cases achieved success after a single LPRF coblation, and there was no postoperative bleeding, dyspnea, dysphagia, dysphonia, or other complications. None required postoperative tracheotomy. The patients were followed for 1 year without recurrence. Before surgical intervention, only 2 (8.7%) of the 23 patients had mild (n = 1) or moderate (n = 1) dysphagia. Postoperative dysphagia was assessed at the 1- and 3-month follow-ups. At 1 month, 5 (21.7%) of 23 patients had mild dysphagia, including 3 (13.0%) reporting new mild dysphagia. However, at 3 months postoperatively, none of patients had any dysphagia. The mean Voice Handicap Index was 11.2 ± 3.7 preoperatively, 7.1 ± 2.8 at 1 month postoperatively, and 4.8 ± 3.1 at 3 months postoperatively; the mean maximum phonation time was 10.8 ± 3.7 seconds preoperatively and 12.6 ± 1.8 and 14.1 ± 3.9 seconds at 1 and 3 months postoperatively, respectively. : LPRF coblation is an effective minimally invasive method for treating ALHs with better voice and swallowing recovery. Edge coagulation before ablation resection may reduce intraoperative bleeding.

摘要

本研究采用支撑喉镜探讨低温等离子射频(LPRF)消融术治疗成人喉血管瘤(ALH)的疗效。回顾性分析23例接受LPRF消融术治疗的ALH患者的临床资料。所有患者在消融切除前均进行边缘凝固。评估术后声音和吞咽情况。23例ALH临床诊断为6例海绵状血管瘤和17例毛细血管瘤。所有23例患者单次LPRF消融术后均获成功,术后无出血、呼吸困难、吞咽困难、声音嘶哑或其他并发症。无一例需要术后气管切开。患者随访1年无复发。手术干预前,23例患者中仅2例(8.7%)有轻度(n = 1)或中度(n = 1)吞咽困难。在术后1个月和3个月的随访中评估术后吞咽困难情况。术后1个月时,23例患者中有5例(21.7%)有轻度吞咽困难,其中3例(13.0%)报告出现新的轻度吞咽困难。然而,术后3个月时,所有患者均无吞咽困难。术前平均嗓音障碍指数为11.2±3.7,术后1个月为7.1±2.8,术后3个月为4.8±3.1;术前平均最长发声时间为10.8±3.7秒,术后1个月和3个月分别为12.6±1.8秒和14.1±3.9秒。LPRF消融术是治疗ALH的一种有效的微创方法,声音和吞咽恢复较好。消融切除前进行边缘凝固可减少术中出血。

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