Zbar R I, Smith R J
Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242-1078, USA.
Otolaryngol Head Neck Surg. 1996 Jan;114(1):18-21. doi: 10.1016/S0194-59989670277-2.
Seventeen cases of unilateral or bilateral vocal fold paralysis were diagnosed in infants younger than 12 months from 1991 to 1994 at the University of Iowa Hospitals and Clinics. Eight (47%) children with left vocal fold paralysis had a history of prior thoracic surgery--two to repair complex congenital anomalies and six to ligate a patent ductus arteriosus. During the study period, a total of 81 patent ductus arteriosus ligations were performed, yielding a 7.4% postoperative incidence of vocal fold paralysis. Seven (41%) children had idiopathic vocal fold paralysis (3 right, 1 left, 3 bilateral). Two (12%) children had VFP caused by central nervous system pathology (1 right, 1 bilateral). Tracheotomy was not required in any case. Prognosis for vocal fold paralysis varied with cause. With left vocal fold paralysis caused by thoracic surgery, no improvement was noted after an average follow-up of 6 months; with idiopathic vocal fold paralysis infants improved within an average of 6 weeks of diagnosis; with vocal fold paralysis caused by central nervous system pathology, treatment of the underlying condition was followed by return of vocal cord function. Irrespective of cause, the morbidity associated with vocal fold paralysis is minimal. Although tracheotomy is not required, careful airway observation is important. Differences and similarities of these results with other studies are discussed.
1991年至1994年期间，爱荷华大学医院及诊所诊断出17例12个月以下婴儿单侧或双侧声带麻痹。8例（47%）左侧声带麻痹患儿有胸部手术史——2例为修复复杂先天性畸形，6例为结扎动脉导管未闭。在研究期间，共进行了81例动脉导管未闭结扎术，术后声带麻痹发生率为7.4%。7例（41%）患儿为特发性声带麻痹（3例右侧、1例左侧、3例双侧）。2例（12%）患儿的声带麻痹由中枢神经系统病变引起（1例右侧、1例双侧）。所有病例均无需气管切开术。声带麻痹的预后因病因不同而异。因胸部手术导致的左侧声带麻痹，平均随访6个月后未见改善；特发性声带麻痹患儿在诊断后平均6周内有所改善；由中枢神经系统病变引起的声带麻痹，在治疗基础疾病后声带功能恢复。无论病因如何，声带麻痹相关的发病率都很低。虽然无需气管切开术，但仔细观察气道很重要。本文还讨论了这些结果与其他研究的异同。
