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[双侧声带麻痹行后索切开术联合部分杓状软骨切除术的疗效研究]

[Study on the efficacy of posterior cordotomy with partial arytenoidectomy in bilateral vocal fold paralysis].

作者信息

Mo Wei, Song Liu, Yu Lingyu, Jing Xingtao, Yang Hui

机构信息

Department of Otorhinolaryngology Head Neck Surgery,West China Hospital,Sichuan University,Chengdu,610041,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Oct;38(10):912-916;922. doi: 10.13201/j.issn.2096-7993.2024.10.006.

Abstract

The aim of this study is to investigate the efficacy of posterior cordotomy with partial arytenoidectomy in bilateral vocal fold paralysis(BVFP). Medical records of 37 patients with BVFP were retrospectively collected, and they were all admitted to the Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, from Jan. 2019 to Dec. 2023. Preoperative and postoperative evaluations of respiratory function, voice quality, and swallowing function were conducted. Postoperatively, 32 out of 37 patients achieved significant relief in breathing difficulties. Out of 29 patients with tracheostomy, 26(89.7%) were successfully decannulated. One month postoperative follow-up revealed a decline in voice quality for 33 patients(89.2%), and 5 cases(13.5%) reported a decrease in swallowing function. However, by three months postoperatively, both voice quality and swallowing function showed significant improvement. Posterior cordotomy with partial arytenoidectomy is an effective surgical method for BVFP, and significantly improve respiratory difficulty despite its impact on voice quality, with no significant impairment to swallowing function, shows significant clinical value.

摘要

本研究旨在探讨后索切开术联合部分杓状软骨切除术治疗双侧声带麻痹(BVFP)的疗效。回顾性收集了37例BVFP患者的病历,这些患者均于2019年1月至2023年12月入住四川大学华西医院耳鼻咽喉头颈外科。对呼吸功能、嗓音质量和吞咽功能进行了术前和术后评估。术后,37例患者中有32例呼吸困难得到明显缓解。在29例行气管切开术的患者中,26例(89.7%)成功拔管。术后1个月随访显示,33例患者(89.2%)嗓音质量下降,5例(13.5%)报告吞咽功能下降。然而,术后3个月时,嗓音质量和吞咽功能均有明显改善。后索切开术联合部分杓状软骨切除术是治疗BVFP的一种有效手术方法,尽管对嗓音质量有影响,但能显著改善呼吸困难,对吞咽功能无明显损害,具有显著的临床价值。

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1
Management of Bilateral Vocal Fold Paralysis: A Systematic Review.双侧声带麻痹的处理:系统评价。
Otolaryngol Head Neck Surg. 2024 Mar;170(3):724-735. doi: 10.1002/ohn.616. Epub 2023 Dec 20.
3
A Study on Quality of Life in Post-tracheostomised Patients.气管切开术后患者的生活质量研究
Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):848-856. doi: 10.1007/s12070-023-03511-z. Epub 2023 Feb 10.
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[Experts consensus on diagnosis and treatment of vocal fold paralysis].[声带麻痹诊断与治疗专家共识]
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Mar 7;56(3):198-209. doi: 10.3760/cma.j.cn115330-20200924-00765.

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