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甲状腺切除术相关单侧声带麻痹的喉返神经再支配的 10 年结果:单外科医生前瞻性研究。

Ten-year outcomes of recurrent laryngeal nerve reinnervation for thyroidectomy-related unilateral vocal fold paralysis: A single-surgeon, prospective study.

机构信息

Department of Otolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.

Department of Otolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.

出版信息

Am J Otolaryngol. 2024 May-Jun;45(3):104242. doi: 10.1016/j.amjoto.2024.104242. Epub 2024 Feb 28.

Abstract

OBJECTIVES

This study evaluated the long-term outcomes of intraoperative recurrent laryngeal nerve (RLN) reinnervation for managing thyroidectomy-related unilateral vocal fold paralysis (UVFP) over a period of 10 years and assessed the long-term efficacy of this technique.

METHODS

This study was conducted between March 2006 and July 2022 at Soonchunhyang University Bucheon Hospital. We enrolled 25 patients who underwent RLN reinnervation via direct neurorrhaphy or ansa cervicalis-to-RLN anastomosis and completed subjective and objective voice measurements over 5 years period. Among these, 10 patients completed voice measurements over 10 years period.

RESULTS

Six months post-RLN reinnervation, most subjective voice parameters and some of objective voice parameters showed significant improvement (p < 0.05). Twelve months after the procedure, most parameters demonstrated significant voice improvements. These improvements remained stable in follow-up examinations 10 years post-RLN reinnervation (p < 0.05).

CONCLUSIONS

With stable voice outcomes over a decade, primary intraoperative RLN reinnervation provides satisfactory voice outcomes for 10 years postoperatively. Concerning the long-term survival of thyroid cancer patients, primary intraoperative RLN reinnervation is the first recommended voice rehabilitation technique for thyroidectomy related permanent UVFP.

摘要

目的

本研究评估了 10 年间术中喉返神经(RLN)再支配治疗甲状腺切除术相关单侧声带麻痹(UVFP)的长期结果,并评估了该技术的长期疗效。

方法

本研究于 2006 年 3 月至 2022 年 7 月在顺天乡大学盆唐医院进行。我们纳入了 25 例通过直接神经吻合或颈袢神经-RLN 吻合术进行 RLN 再支配的患者,并在 5 年内完成了主观和客观的嗓音测量。其中,10 例患者完成了 10 年的嗓音测量。

结果

RLN 再支配后 6 个月,大多数主观嗓音参数和一些客观嗓音参数均有显著改善(p<0.05)。术后 12 个月,大多数参数显示出显著的嗓音改善。这些改善在 RLN 再支配后 10 年的随访检查中保持稳定(p<0.05)。

结论

RLN 再支配术后 10 年内,嗓音结果稳定,为术后 10 年提供了满意的嗓音结果。考虑到甲状腺癌患者的长期生存,原发性术中 RLN 再支配是治疗甲状腺切除术相关永久性 UVFP 的首选嗓音康复技术。

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