摘要
目的探讨声带后端切开术治疗双侧声带麻痹的疗效。方法 2009年1月～2010年6月共5例双侧声带麻痹患者在我院住院行声带后端切开术治疗。单侧声带后端切开术3例,双侧声带后端切开术2例。女性4例,男性1例,年龄30～68岁,甲状腺手术后双侧声带麻痹4例,颈部外伤后双侧声带麻痹1例。入院前已行气管切开3例,要求拔管而入院。2例因呼吸困难、憋气、夜间不能入睡而入院,术中先局麻气管切开后全麻下再行手术。结果术后次日所有患者均顺利堵管,无呼吸不畅,喉镜检查声门裂开放程度能维持正常呼吸。术后8 d拔出气管套管1例,其余4例术后3个月复查,声门裂宽大,3例顺利拔除气管套管,1例患者因发现肺转移需要放射性131I治疗,建议患者继续堵管,没有拔除气管套管。所有患者对自己的发音功能感到满意而且无进食呛咳现象。结论声带后端切开术治疗双侧声带外展麻痹疗效可靠、操作简单、手术时间短、微创,应大力推广。
OBJECTIVE To evaluate the efficacy of posterior cordotomy for patients with bilateral paralysis of the vocal cord.METHODS Five patients with bilateral paralysis of the vocal cord underwent CO2 laser assisted posterior cordotomy for decannulation in our hospital from Jan.2009 to June.2010.Unilateral posterior cordotomy was performed in 3 cases and bilateral posterior cordotomy in 2 cases.There were one male and four female patients with their age ranged from 30 to 68 years.The causes of the bilateral paralysis of the vocal cord were total thyroidectomy in 4 cases and cervical trauma in one case.Three cases were previously tracheotomized before hospitalization and other two patients underwent tracheotomy before posterior cordotomy due to severe dyspnea.RESULTS Complications were not encountered in the CO2 laser assisted posterior cordotomy.The tracheotomy tube was plugged next day after posterior cordotomy.All of the five patients were breathing well without any effort.One patient was decannulated 8 days after operation,other 4 cases were reexamined 3 months later.The laryngoscopy showed enough glottis for breathing.Three cases were decannulated.One patient was not decannulated because lung metastasis of thyroid cancer,even she was breathing without any effort for plugged tracheotomy tube.All the patients satisfied with their voice and no evidence of clinical aspiration occurred.CONCLUSION Our limited experience showed that CO2 laser assisted posterior cordotomy is an effective and reliable surgical procedure for patients with bilateral paralysis of the vocal cord.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2011年第8期445-447,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
声带麻痹
声带后端切开术
Vocal Cord Paralysis
posterior cordotomy
