鼻内镜显像系统在支撑喉镜下声带息肉手术中的应用

Nasal endoscopy in operations for vocal cord polyps under sustaining laryngoscope

目的 探讨支撑喉镜下声带息肉切除的手术方法和手术效果。方法 在支撑喉镜声带息肉切除术中运用鼻内镜帮助暴露。 结果 12 8例中 ,10 0例 ( 78 1% )治愈 ,2 8例 ( 2 1 9% )有效。Ⅰ型 5 0例中治愈 4 3例 ( 86 % ) ,有效 7例 ( 14 % ) ;Ⅱ型 4 0例中治愈 38例 ( 95 % ) ,有效 2例 ( 5 % ) ;Ⅲ型 38例中治愈 19例 ( 5 0 % ) ,有效 19例 ( 5 0 % )。Ⅰ、Ⅱ型治疗效果明显优于Ⅲ型 ( χ2 =13 4 4 2 ,2 0 0 5 7;P =0 0 0 0 )。随访 5个月～ 4年 ,平均 2年 ,无复发和并发症。 结论 在支撑喉镜声带息肉手术中运用鼻内镜能减轻对患者创伤性操作 ,并缩短治疗时间 。

Objective To explore the techniques and effects of excision of vocal cord polyps under sustaining laryngoscope. Medthods Nasal endoscopy was used to obtain a better exposure during excision of vocal cord polyps under sustaining laryngoscope. Results Out of the 128 cases, 100 cases (78 1%) were cured and 28 cases (21 9%) were improved. Among 50 cases of type Ⅰ polyps, 43 (86%) were cured and 7 (14%) improved; among 40 cases of type Ⅱ polyps, 38 (95%) were cured and 2 (5%) improved; among 38 cases of type Ⅲ, 19 (50%) were cured and 19 (50%) improved. The therapeutic effects in cases of type Ⅰ and Ⅱ polyps were significantly better than those in cases of type Ⅲ polyps ( χ 2=13 442 and 20 057; P =0 000). Follow up for 5 months ～ 4 years (mean, 2 years) found no recurrence and complications. Conclusions Application of nasal endoscopy in operations for vocal cord polyps under sustaining laryngoscope may reduce the invasion during operation, shorten the operation time, and avoid or minimize the occurrence of complications.