摘要
目的探讨颈袢主支喉返神经吻合术治疗甲状腺手术引起的喉返神经损伤单侧声带麻痹的远期疗效。方法对1990年10月至2010年1月因甲状腺手术致单侧声带麻痹的325例患者施行颈袢主支喉返神经吻合术，对其疗效进行回顾性分析。结果动态喉镜随访发现术后声门闭合程度、声带边缘直线性、患侧声带位置、声带振动的对称性和规律性与术前相比有明显改善（P〈0．01），嗓音功能评价的各种主客观参数（GRBAS评分、基频微扰，振幅微扰，噪谐比，最长发声时间）术后与术前比较，均有显著改善（P〈0．01）；93．5％（304／325）的患者嗓音恢复正常，有效率达98．8％（321／325）。术后喉肌电图检查证实麻痹侧喉肌获得充分的神经再支配。结论颈袢主支喉返神经吻合术治疗后甲状腺手术单侧喉返神经损伤声带麻痹患者嗓音功能可恢复正常，远期疗效非常满意。
Objective To evaluate long-term outcome of laryngeal reinnervation using the main branch of the ansa cervicalis for the treatment of unilateral vocal fold paralysis （UVFP） caused by thyroid surgery. Methods From Oct. 1990 to Jan. 2010, a total of 325 UVFP patients who underwent main branch of ansa eervicalis-to-recurrent laryngeal nerve （RLN） anastomosis were enrolled in the study. We retrospectively analyzed the efficacy of the reinnervation surgery using videostroboscopy, vocal function assessment （acoustic analysis, perceptual evaluation and maximum phonation time ）, and laryngeal eleetromyography. Results Videostroboseopy showed that the glottie closure, vocal fold edge, vocal fold position, phase symmetry and regularity were significantly improved postoperatively. The vocal function parameters （GRBAS scale, jitter, shimmer, noise to harmonies ratio and maximum phonation time） were also significantly improved postoperatively （ P 〈 0. O1 ）, as compared to corresponding preoperative values. Voice recovered to a normal level in 93.5% （304/325） patients, and the effective rate was 98. 8% （321/325）. Postoperative laryngeal electromyography confirmed successful reinnervation of laryngeal muscle. Condusions Laryngeal reinnervation using the main branch of ansa cervicalis is a feasible and effective approach for treatment of UVFP patients caused by thyroid surgery, with satisfactory long-term results.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第4期267-271,共5页
Chinese Journal of General Surgery
关键词
喉返神经
声带麻痹
甲状腺切除术
神经修复
Recurrent laryngeal nerve
Vocal cord paralysis
Thyroideetomy
Reinnervation
