Rontal M, Rontal E
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor.
Ann Otol Rhinol Laryngol. 1994 Aug;103(8 Pt 1):583-9. doi: 10.1177/000348949410300801.
As experience has increased in the treatment of bilateral vocal cord fixation, a significant and fundamental refinement in the concept of repair has evolved. By the use of selective tenotomy of the interarytenoid and thyroarytenoid muscles, the arytenoid and the vocal cord can be made to move away from the midline and thus open the glottis. This has allowed a drastic reduction in the amount of arytenoid that must be removed and prevents both aspiration and arthritis of the joint with subsequent stiffness. The procedure can be performed as an endoscopic or microscopic open procedure. All eight patients treated by this method have been decannulated by 6 weeks postoperation, have returned to full function, have not had aspiration, and have no worsening of their voices. The use of this concept and technique has led to a relatively safe and reliable method of rehabilitating patients with bilateral midline vocal cord paralysis.
随着双侧声带固定治疗经验的增加，修复概念有了重大且根本性的改进。通过选择性切断杓间肌和甲杓肌，可使杓状软骨和声带动离中线，从而打开声门。这使得必须切除的杓状软骨量大幅减少，并防止了误吸和关节关节炎及随后的僵硬。该手术可作为内镜手术或显微开放手术进行。采用这种方法治疗的所有8例患者在术后6周均已拔管，恢复了全部功能，未发生误吸，声音也未恶化。这一概念和技术的应用产生了一种相对安全可靠的方法，用于双侧中线声带麻痹患者的康复。
