摘要
目的对声带外侧自体脂肪注射填充术方法选择、预后及其影响因素进行研究,探讨声带外侧自体脂肪注射在声门闭合不良性发声障碍治疗中的价值。方法病例选择:29例声门闭合不良、发声障碍患者,27例为单侧声带麻痹(麻痹时间均超过半年),2例为声带萎缩。手术选择:全麻支撑喉镜下,应用特制Brunning高压脂肪注射器进行自体脂肪声带外侧注射。患者手术前后均行嗓音声学、气流动力学及频闪喉镜检查,确定患者发音质量及疗效。结果术后随诊10～18个月,24例患者发声明显改善,2例发声好转,3例无效。注射1个月后脂肪部分吸收,声门闭合程度及发音逐渐改善。3～6个月声带振动、声门闭合正常,发声明显改善,音质稳定,主、客观声学评价及气流动力学参数改善明显(P<0.01)。结论单侧声带麻痹或声带萎缩引起的声门闭合不良,选择声带外侧声门旁间隙脂肪注射手术,使声带膜部内移,改善声门闭合,并保留声带振动特性,患者可获得良好的发音效果。
OBJECTIVE To study the efficacy of the lateral vocal fold injection of autogenous fat for vocal fold insufficiency. METHODS Twenty nine patients with vocal fold insufficiency were treated in our department with fat injection. Deep lateral vocal fold injection was performed through direct laryngoscope under general anesthesia. Fat was injected into the lateral aspect of the vocal fold （paraglottic space） using a special high pressure Brunning injector. The perceptual acoustic,phonatory function,and video laryngostroboscopy were evaluated before and after operation. RESULTS All the patients were followed up for 10 to 18 months. There were 24 patients with excellent results,2 patients with improvement, and 3 patients with no improvement. Phonatory function showed significant improvement（P〈0.01）. Video laryngostroboscopy showed significant improvement of the glottic closure. The amplitude of vocal fold vibration and excursion of the mucosal wave were excellent. CONCLUSION Lateral vocal fold injection of autogenous fat was a useful and safe procedure for surgical correction of glottal incompetence due to vocal fold paralysis or atrophy. Bulking the vocal fold from medial to lateral,by injecting autogenous fat into the paraglottic space,allows to create the nearly closed glottic configuration and the vibratory surface is relative normal.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2006年第7期499-502,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
喉注射成形术
脂肪组织
语音障碍
声带麻痹
声门
injection laryngoplasty
Adipose Tissue
Voice Disorders
Vocal Cord Paralysis
Glottis
