Daniels S K, Mahoney M C, Lyons G D
Speech Pathology Section, VA Medical Center, New Orleans, LA 70146, USA.
Ear Nose Throat J. 1998 Jun;77(6):470, 473-5.
Persistent dysphagia and dysphonia following anterior cervical spine surgery have been underdiagnosed. Understanding the physiologic mechanism resulting in post-surgical dysphagia and dysphonia is essential to providing appropriate treatment. Two cases of protracted dysphagia and dysphonia following left anterior cervical corpectomy were reviewed. Videofluoroscopic evaluation, videostroboscopic assessment and laryngeal nerve-conduction testing were used to determine swallowing, vocal fold and cranial nerve integrity; to assess the ability to achieve oral nutrition; and to direct therapy and surgical procedures to improve swallowing and voice. With a multidisciplinary approach, the physiologic problems of post-surgical dysphagia and dysphonia can be addressed and therapeutic and/or surgical treatments initiated promptly.
颈椎前路手术后持续存在的吞咽困难和发音困难一直未得到充分诊断。了解导致术后吞咽困难和发音困难的生理机制对于提供适当治疗至关重要。回顾了两例左颈椎前路椎体次全切除术后长期吞咽困难和发音困难的病例。使用视频荧光透视评估、频闪喉镜评估和喉神经传导测试来确定吞咽、声带和颅神经的完整性;评估实现经口营养的能力;并指导改善吞咽和发声的治疗及外科手术。通过多学科方法,可以解决术后吞咽困难和发音困难的生理问题,并迅速启动治疗和/或手术治疗。