Wani M K, Yarber R, Hengesteg A, Rosen C, Woodson G E
Department of Otolaryngology-Head and Neck Surgery, University of Tennessee School of Medicine, Memphis 38163, USA.
Ann Otol Rhinol Laryngol. 1996 Nov;105(11):857-62. doi: 10.1177/000348949610501103.
Bilateral laryngeal paralysis can result in severe airway compromise. A widely accepted treatment is endoscopic laser total arytenoidectomy (TA); however, vocal results are usually poor. An alternative approach, resection of only the medial portion of the arytenoid (medial arytenoidectomy [MA]), has the potential for less vocal impairment, but may not provide a sufficient airway. Laryngeal resistance (LR) was measured in vivo and ex vivo in 12 adult mongrel dogs with bilateral laryngeal paralysis after TA, MA, or no surgery (controls). The LR was significantly lower than in controls in both TA and MA, but there was no significant difference between TA and MA. Glottic area was also significantly higher in both MA and TA compared to controls, but again, there was no significant difference between TA and MA. Phonation could be elicited in all controls and 2 of 4 dogs with MA, but no dogs with TA. Our results show that MA offers airway improvement similar to that with TA and also has the potential for better vocal function.
双侧喉麻痹可导致严重的气道梗阻。一种广泛接受的治疗方法是内镜激光全杓状软骨切除术（TA）；然而，发声效果通常较差。另一种方法是仅切除杓状软骨的内侧部分（内侧杓状软骨切除术[MA]），有可能减少发声障碍，但可能无法提供足够的气道。在12只患有双侧喉麻痹的成年杂种犬体内和体外测量了TA、MA或未手术（对照组）后的喉阻力（LR）。TA组和MA组的LR均显著低于对照组，但TA组和MA组之间无显著差异。与对照组相比，MA组和TA组的声门面积也显著更高，但同样，TA组和MA组之间无显著差异。所有对照组以及4只接受MA手术的犬中有2只能够发声，但接受TA手术的犬均不能发声。我们的结果表明，MA与TA一样能改善气道，并且有可能具有更好的发声功能。
