Ribári O, Hirschberg A, Szabó G, Molnár B
Semmelweis University of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, Budapest, Hungary.
Acta Otolaryngol Suppl. 1997;527:74-6. doi: 10.3109/00016489709124040.
A total of 1032 vocal cord operations have been performed by means of CO2 laser in the Department of Otorhinolaryngology, Head and Neck Surgery of the Semmelweis University of Medicine in Budapest in the past 10 years. There were 687 benign cases and 345 malignant cases of lesions discovered. The procedures were performed under general anesthesia in many instances with jet narcosis--in laryngomicroscopic exposure. The operations were preceded by careful objective diagnostics, such as videolaryngostroboscopy, fiberoscopy, voice analysis, airflow and resistance measurements, while the voice and breathing functions were monitored postoperatively. Our policy in the therapy of the benign lesions was always to use a minimally invasive technique, avoiding damage to the anterior commissure, the vocal ligament and the subglottic space. We have experienced a 3-year survival rate in 87% of the patients with vocal cord carcinomas. According to the results of the past 10 years it is proven that the CO2 laser technique is an efficient method as well in the surgery of the benign and malignant vocal cord lesions, as in the bilateral vocal cord paralysis. Laser surgery might also prevent malignant transformation in precancerous vocal cord diseases.
在过去10年里,布达佩斯塞梅尔维斯医科大学耳鼻咽喉头颈外科使用二氧化碳激光共进行了1032例声带手术。发现687例良性病变和345例恶性病变。许多手术在全身麻醉下进行,采用喷射麻醉——在喉镜显微镜下暴露。手术前进行了仔细的客观诊断,如视频喉镜频闪检查、纤维喉镜检查、语音分析、气流和阻力测量,同时术后监测语音和呼吸功能。我们对良性病变的治疗策略始终是采用微创技术,避免损伤前联合、声带韧带和声门下间隙。我们观察到声带癌患者的3年生存率为87%。根据过去10年的结果证明,二氧化碳激光技术在良性和恶性声带病变手术以及双侧声带麻痹手术中都是一种有效的方法。激光手术还可能预防癌前声带疾病的恶变。