Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Auris Nasus Larynx. 2024 Aug;51(4):703-707. doi: 10.1016/j.anl.2024.05.002. Epub 2024 May 15.
Laryngeal framework surgery is a widely accepted treatment for unilateral vocal fold paralysis with good functional outcomes. Recently, with the aging of the population, opportunities to perform this procedure in elderly patients have increased; however, the safety and efficacy of this procedure in elderly patients has not been established. Therefore, this study aimed to investigate the safety and functional outcomes of laryngeal framework surgery in elderly patients.
Between January 2008 and December 2017, 97 patients with unilateral vocal fold paralysis underwent laryngeal framework surgery, and 71 among them completed pre- and post-operative voice function evaluations. The clinical course of these 71 patients were retrospectively reviewed.
Out of 71 patients, 35 were assigned to the younger group (< 65 years) and 36 to the elderly group (≥ 65 years). Complications included post-operative edema and submucosal hematoma that were safely managed in all cases, and no differences were identified between the groups. Significant improvements were observed in maximum phonation time (MPT), mean flow rate, alternating current/direct current ratio, pitch perturbation quotient, amplitude perturbation quotient, and noise-to-harmonic ratio in both groups, and multivariate analysis of variance revealed greater improvement in the younger group in MPT.
Laryngeal framework surgeries for unilateral vocal fold paralysis are safe and effective, regardless of age. Better improvement was observed in the younger group in the MPT suggesting that the effects of laryngeal framework surgeries is more likely to be present in the younger group than in the elderly.
喉框架手术是治疗单侧声带麻痹的一种广泛接受的治疗方法，具有良好的功能效果。最近，随着人口老龄化，为老年患者实施该手术的机会增加了；然而，该手术在老年患者中的安全性和疗效尚未得到证实。因此，本研究旨在探讨喉框架手术在老年患者中的安全性和功能效果。
2008 年 1 月至 2017 年 12 月，97 例单侧声带麻痹患者接受了喉框架手术，其中 71 例完成了术前和术后的嗓音功能评估。回顾性分析了这 71 例患者的临床过程。
71 例患者中，35 例患者年龄<65 岁（年轻组），36 例患者年龄≥65 岁（老年组）。并发症包括术后水肿和黏膜下血肿，所有患者均安全处理，两组间无差异。两组的最大发音时间（MPT）、平均流量、交流/直流比、音高微扰商、幅度微扰商和噪声-谐波比均有显著改善，多变量方差分析显示年轻组的 MPT 改善更为显著。
喉框架手术治疗单侧声带麻痹是安全有效的，与年龄无关。年轻组在 MPT 方面观察到更好的改善，这表明喉框架手术的效果在年轻组中比在老年组中更有可能出现。
