Nakayama M, Ford C N, Bless D M
Department of Surgery, University of Wisconsin-Madison 53792-3236.
Otolaryngol Head Neck Surg. 1993 Sep;109(3 Pt 1):493-8. doi: 10.1177/019459989310900318.
Although vocal fold augmentation by Teflon injection has been the mainstay of treatment for glottic insufficiency for three decades, the success and safety of this treatment have been overstated. Twenty-eight patients who manifested poor or complicated Teflon results between 1984 and 1991 were evaluated using acoustic, aerodynamic, videostroboscopic, perceptual, and subjective patient self-evaluation of voice, both before and after our management of these complications. Most of these had Teflon granulomas; subglottic overfilling was the most common condition. In most instances such management included microsurgical removal of the Teflon granuloma. Voice measures that were abnormal before correction tended to improve and move into the normal range, although the resultant voices were not totally normal. Degree of improvement varied depending on the Teflon-induced tissue changes and the methods of correction subsequently used. The worst results were in patients with scarring, atrophy, and bilaterally mobile vocal folds, for whom Teflon should never have been injected. Teflon injection should be reserved for those instances in which it is clearly indicated and the surgeon is skilled in the technique of intrafold injection.
尽管三十年来，通过注射聚四氟乙烯进行声带增厚一直是声门功能不全的主要治疗方法，但这种治疗方法的成功率和安全性被高估了。对1984年至1991年间出现聚四氟乙烯治疗效果不佳或出现并发症的28例患者，在我们处理这些并发症之前和之后，分别使用声学、空气动力学、频闪喉镜检查、听觉以及患者对声音的主观自我评价等方法进行了评估。其中大多数患者患有聚四氟乙烯肉芽肿；声门下填充过度是最常见的情况。在大多数情况下，这种处理包括聚四氟乙烯肉芽肿的显微手术切除。矫正前异常的嗓音指标往往会有所改善并进入正常范围，尽管最终的嗓音并非完全正常。改善程度因聚四氟乙烯引起的组织变化以及随后使用的矫正方法而异。结果最差的是那些有瘢痕、萎缩且双侧声带可活动的患者，对他们本就不应注射聚四氟乙烯。聚四氟乙烯注射应仅用于明确适用的情况，并且外科医生应熟练掌握声带内注射技术。
