Cotter C S, Avidano M A, Crary M A, Cassisi N J, Gorham M M
Department of Otolaryngology, University of Florida, Gainesville, USA.
Otolaryngol Head Neck Surg. 1995 Dec;113(6):671-3. doi: 10.1016/S0194-59989570003-X.
Type I thyroplasty has become a primary surgical choice for voice restoration in patients with glottal incompetence. This study examines factors associated with laryngeal complications after type I thyroplasty. Ten laryngoscopic variables were analyzed from preoperative, intraoperative, and postoperative videolaryngoscopies of 51 patients undergoing 58 medialization procedures. Ten patient and operative variables were examined by medical record review. Major complications were defined as wound hemorrhage, airway obstruction, or prosthesis extrusion. Minor complications were defined as vocal fold hematoma without airway obstruction or prosthesis movement. The major complication rate was 8.6%, and the minor complication rate was 29%. No delayed hemorrhage or airway obstruction occurred. Prosthesis extrusion occurred in five (8.6%) patients 1 week to 5 months after surgery. Extrusion was associated with suboptimal prosthesis placement in 80% of cases. Two patients retained excellent glottal closure despite extrusion. Vocal fold hematoma was identified in 14 (24%) cases and resolved within 1 week. Prosthesis movement occurred in three (5%) patients 1 week to 6 months after surgery and resulted in poor glottal closure. All patients with prosthesis extrusion or movement were female. Type I thyroplasty remains a safe outpatient procedure with few major complications. Prosthesis extrusion was associated with suboptimal prosthesis placement and may or may not result in poor glottal closure. Minor vocal fold hematomas were relatively frequent, resolved rapidly, and were not associated with airway obstruction. Female patients may be more prone to complications because of their small laryngeal size.
I型甲状成形术已成为声门功能不全患者嗓音恢复的主要手术选择。本研究探讨I型甲状成形术后与喉部并发症相关的因素。对51例接受58次内移手术患者的术前、术中和术后电子喉镜检查的10个喉镜变量进行了分析。通过病历回顾检查了10个患者和手术变量。主要并发症定义为伤口出血、气道梗阻或假体脱出。次要并发症定义为无气道梗阻或假体移位的声带血肿。主要并发症发生率为8.6%，次要并发症发生率为29%。未发生迟发性出血或气道梗阻。5例（8.6%）患者在术后1周 至5个月发生假体脱出。80%的病例中，假体脱出与假体放置不当有关。尽管假体脱出，仍有2例患者声门闭合良好。14例（24%）患者出现声带血肿，并在1周内消退。3例（5%）患者在术后1周 至6个月发生假体移位，导致声门闭合不佳。所有假体脱出或移位的患者均为女性。I型甲状成形术仍是一种安全的门诊手术，主要并发症较少。假体脱出与假体放置不当有关，可能导致也可能不导致声门闭合不佳。较小的声带血肿相对常见，消退迅速，且与气道梗阻无关。女性患者可能因其喉部较小而更容易发生并发症。
