Snow J B
Otolaryngol Clin North Am. 1984 Feb;17(1):91-100.
In general, misuse and abuse of the voice in the form of using the voice too loudly and too long and affecting a fundamental frequency that is too low produce chronic changes in the lamina propria while inhalation of irritants produces changes in the epithelium of the true vocal cords. Voice therapy plays an essential role in the preoperative and postoperative management of the patient. The use of the operative microscope under general anesthesia has permitted the regular preservation of the external elastic lamina, which is necessary for the restoration of the voice to its full dynamic and frequency ranges. Resection of the left recurrent laryngeal nerve is of great value in the treatment of spastic dysphonia. In the paralyzed larynx, injection of Teflon paste is of proven value in restoring the voice in permanent unilateral recurrent laryngeal nerve paralysis. Reinnervation procedures for unilateral and bilateral recurrent laryngeal nerve and superior laryngeal nerve paralysis must at this time be considered developmental.
一般来说，以过高音量、过长时间使用嗓音以及影响到过低基频的形式滥用和过度使用嗓音会导致固有层发生慢性变化，而吸入刺激性物质会使真声带的上皮发生变化。嗓音治疗在患者的术前和术后管理中起着至关重要的作用。在全身麻醉下使用手术显微镜能够常规保留外部弹性层，这对于将嗓音恢复到其完整的动态和频率范围是必要的。切除左侧喉返神经在痉挛性发音障碍的治疗中具有重要价值。在麻痹性喉中，注射特氟龙糊剂在恢复永久性单侧喉返神经麻痹的嗓音方面已被证明具有价值。此时，针对单侧和双侧喉返神经及喉上神经麻痹的再支配手术必须被视为仍在发展阶段。
