Jóri J, Rovó L, Czigner J
Department of Otorhinolaryngology, Albert Szent-Györgyi Medical University, Szeged, Hungary.
Eur Arch Otorhinolaryngol. 1998;255(7):375-8. doi: 10.1007/s004050050081.
Bilateral vocal cord palsy due to a lesion of the recurrent laryngeal nerves is a serious complication of thyroid operations, with the airway obstruction usually necessitating tracheostomy. In the cases presented, a stable airway was ensured with endolaryngeal cord laterofixation instead of tracheostomy. The operation was performed with the endo-extralaryngeal needle carrier instrument devised by Lichtenberger. During the operation, only minor surgical trauma occurred in the larynx. The fixing thread was then removed following recovery of contralateral vocal cord function, resulting in an improvement in the voice. Four patients are described who suffered bilateral recurrent laryngeal nerve palsy after thyroid gland operations. During the follow-up period of 3-12 months, airway stability was demonstrated by regular spirometric measurements. The simple method recommended spares patients the possible complications of tracheostomy.
由于喉返神经损伤导致的双侧声带麻痹是甲状腺手术的严重并发症,气道梗阻通常需要进行气管切开术。在本文所介绍的病例中,通过喉内声带外侧固定术确保了气道稳定,而无需进行气管切开术。手术使用了由利希滕贝格设计的内外喉针持器械。手术过程中,喉部仅出现轻微手术创伤。对侧声带功能恢复后,拆除固定线,声音得到改善。本文描述了4例甲状腺手术后发生双侧喉返神经麻痹的患者。在3至12个月的随访期内,通过定期肺活量测定证明气道稳定。所推荐的这种简单方法使患者避免了气管切开术可能带来的并发症。