Zhou Shitong, Liu Lei, Yang Yucheng, Mo Hailan, Wei Lei, Xu Dan, Yang Yanyan, Luo Rui, Hu Jie, Fang Hongyan
Department of Otorhinolaryngology Head and Neck Surgery,Chongqing General Hospital,Chongqing University,Chongqing,401147,China.
Department of Otorhinolaryngology Head and Neck Surgery,Mianyang Central Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Oct;38(10):928-934. doi: 10.13201/j.issn.2096-7993.2024.10.009.
To conduct a systematic description and meta-analysis of the treatment of unilateral vocal cord paralysis(UVCP) with recurrent laryngeal nerve reinnervation through literature search, and to analyze the therapeutic effect of recurrent laryngeal nerve reinnervation on improving vocal function in UVCP. Electronic databases Pubmed, Web of Science, EMBASE, Cochrane Library, CNKI, and Wanfang databases were searched using relevant keywords and screened in strict accordance with the inclusion and exclusion criteria, and quality evaluations were conducted. Reported treatment outcomes were measured by relevant data extracted from literature, such as auditory perception assessment(GRBAS), voice handicap index(VHI), maximal phonation time(MPT), jitter, shimmer, and noise harmonic ratio(NHR), etc. Meta-analysis was performed by Revman5.3 and heterogeneity was analyzed using fixed effects or random effects models. Eight articles were included in this study, all of which showed that the postoperative maximum phonation time of patients was significantly prolonged compared to preoperative, while the postoperative GRBAS score, Jitter, Shimmer, and NHR decreased compared to preoperative with statistical significance. The innervation of the internal laryngeal muscle was obtained through the reinnervation of the recurrent laryngeal nerve, which effectively improved the patient's vocal function and had a good long-term therapeutic effect. Although there was no difference in the efficacy of surgical methods for reconstructing the recurrent laryngeal nerve, the anastomosis between ansa cervicalis nerve and the recurrent laryngeal nerve is more ideal. Further randomized controlled studies with longer follow-up periods and larger samples will increase the credibility of their effectiveness.
通过文献检索对喉返神经再支配治疗单侧声带麻痹(UVCP)进行系统描述和荟萃分析,分析喉返神经再支配对改善UVCP患者嗓音功能的治疗效果。使用相关关键词检索电子数据库PubMed、Web of Science、EMBASE、Cochrane图书馆、中国知网和万方数据库,并严格按照纳入和排除标准进行筛选,同时进行质量评估。通过从文献中提取的相关数据来衡量报告的治疗结果,如听觉感知评估(GRBAS)、嗓音障碍指数(VHI)、最长发声时间(MPT)、抖动、闪烁和噪声谐波比(NHR)等。采用Revman5.3进行荟萃分析,并使用固定效应或随机效应模型分析异质性。本研究纳入8篇文章,所有文章均显示患者术后最长发声时间较术前显著延长,而术后GRBAS评分、抖动、闪烁和NHR较术前降低,差异有统计学意义。通过喉返神经再支配获得喉内肌的神经支配,有效改善了患者的嗓音功能,且具有良好的长期治疗效果。虽然重建喉返神经的手术方法在疗效上没有差异,但颈袢神经与喉返神经的吻合更为理想。进一步开展随访时间更长、样本量更大的随机对照研究将提高其有效性的可信度。