Tucker H M
Head Neck Surg. 1979 Jan-Feb;1(3):235-42. doi: 10.1002/hed.2890010307.
Our high-speed and increasingly aggressive society, coupled with a continuing rise in necessary surgery of the neck and adjacent areas, accounts for the current increase in patients affilicted with vocal-cord paralysis. Such patients may sustain relatively little persistent loss of function (e.g., when only one cord is involved, which then regains function or becomes compensated) or considerable loss (as in cases of bilateral vocal-cord paralysis). To improve on existing methods of dealing with these problems, the author has developed and refined the nerve-muscle-pedicle technique for reinnervating paralyzed muscles. A nerve-muscle pedicle obtained from the ansa hypoglossi branch to the omohyoid muscle or another strap muscle can be used to selectively reinnervate the posterior cricoarytenoid muscle in cases of bilateral-cord paralysis, or for selective reinnervation of the lateral thyroarytenoid muscle in cases of unilateral-cord paralysis. The bilateral reinnervation technique showed a 90% success rate in 90 patients, as demonstrated by their ability to sustain reasonable day-to-day activity without needing a tracheotomy tube and without manifesting further loss of voice. The unilateral technique has yielded promising results in a limited number of carefully selected patients.
我们这个高速且竞争日益激烈的社会，再加上颈部及相邻区域必要手术的持续增加，导致了目前声带麻痹患者数量的上升。这类患者可能仅遭受相对较小的持续性功能丧失（例如，仅一侧声带受累，随后恢复功能或得到代偿），也可能出现严重的功能丧失（如双侧声带麻痹的情况）。为改进处理这些问题的现有方法，作者研发并完善了用于使麻痹肌肉重新获得神经支配的神经 - 肌肉蒂技术。从舌下神经袢至肩胛舌骨肌或另一带状肌的分支获取的神经 - 肌肉蒂，可用于在双侧声带麻痹病例中选择性地使环杓后肌重新获得神经支配，或在单侧声带麻痹病例中选择性地使甲杓侧肌重新获得神经支配。双侧神经再支配技术在90例患者中成功率达90%，这体现在他们能够维持合理的日常活动，无需气管切开管，且未出现进一步的声音丧失。单侧技术在少数精心挑选的患者中也取得了令人鼓舞的结果。
