特发性声带麻痹患者不同麻痹侧别喉返神经损伤的对比分析
A comparative analysis of laryngeal nerve damage in patients with idiopathic vocal cord paralysis exhibiting different paralytic sides.
作者信息
Liu Xiao-Hong, Yan Jing, Li Na, Zhang Qing-Qing, Xie Meng, Guo Rui-Xin, Du Xiao-Ying, Chen Yang-Juan, Kong De-Min, Yang Min-Juan, Ren Xiao-Yong
机构信息
Department of Otolaryngology-Head and Neck Surgery The Second Affiliated Hospital of Xi'an Jiao Tong University Xi'an China.
出版信息
Laryngoscope Investig Otolaryngol. 2024 Jan 5;9(1):e1205. doi: 10.1002/lio2.1205. eCollection 2024 Feb.
OBJECTIVE
To assess the extent of recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN) damage in patients with idiopathic vocal cord paralysis (IVCP) exhibiting different paralytic sides.
METHODS
A total of 84 IVCP cases were evaluated using stroboscopic laryngoscopy, voice analysis, and laryngeal electromyography (LEMG). The results were compared between patients with left-sided paralysis and right-sided paralysis based on different disease courses (less than or more than 3 months).
RESULTS
Initially, the average age and disease progression of IVCP patients were found to be similar regardless of the side of paralysis ( > .05). Additionally, there were no significant variations in voice indicators, such as MPT, DSI, and VHI, between IVCP patients with left and right vocal cord paralysis ( > .05). Furthermore, no disparities were detected in the latencies and amplitudes of the paralyzed RLN and SLN, as well as the durations and amplitudes of the action potentials in the paralyzed TM and PCM, among IVCP patients with left and right vocal cord paralysis ( > .05). Notably, the amplitudes of the left paralytic CM were significantly lower than those of the right paralytic CM (0.45 vs. 0.53, = -2.013, = .044). In addition, no disparities were observed in APDs and amplitudes between the ipsilateral PCM and TM, either for patients with left or right vocal fold paralysis ( > .05). Finally, all the IVCP patients were subdivided into two subgroups according to different disease course (less than or more than 3 months), and in each subgroup, the comparison of voice indicators and LEMG results in IVCP patients with left or right vocal fold paralysis were similar with the above findings ( > .05).
CONCLUSION
Overall, the degree of RLN and SLN damage appeared to be similar in IVCP patients with left and right vocal cord paralysis, provided that the disease course was comparable.
LEVEL OF EVIDENCE
目的
评估表现出不同麻痹侧的特发性声带麻痹（IVCP）患者喉返神经（RLN）和喉上神经（SLN）损伤的程度。
方法
总共84例IVCP患者接受了频闪喉镜检查、嗓音分析和喉肌电图（LEMG）评估。根据不同病程（少于或多于3个月），对左侧麻痹和右侧麻痹患者的结果进行比较。
结果
最初发现，无论麻痹侧如何，IVCP患者的平均年龄和疾病进展相似（P＞0.05）。此外，左侧和右侧声带麻痹的IVCP患者在嗓音指标（如MPT、DSI和VHI）方面没有显著差异（P＞0.05）。此外，左侧和右侧声带麻痹的IVCP患者在麻痹的RLN和SLN的潜伏期和波幅，以及麻痹的杓横肌（TM）和环杓后肌（PCM）动作电位的持续时间和波幅方面均未检测到差异（P＞0.05）。值得注意的是，左侧麻痹复合肌肉动作电位（CM）的波幅显著低于右侧麻痹CM的波幅（0.45对0.53，t = -2.013，P = 0.044）。此外，无论是左侧还是右侧声带麻痹患者，同侧PCM和TM之间的动作电位持续时间（APD）和波幅均未观察到差异（P＞0.05）。最后，所有IVCP患者根据不同病程（少于或多于3个月）分为两个亚组，在每个亚组中，左侧或右侧声带麻痹的IVCP患者的嗓音指标和LEMG结果比较与上述结果相似（P＞0.05）。
结论
总体而言，在病程相当的情况下，左侧和右侧声带麻痹的IVCP患者中RLN和SLN损伤程度似乎相似。
证据级别
4级。
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