喉病的激光治疗——附14例报告

Laser Therapy in the Management of Laryngopathy (An Analysis of 14 Cases)

为探讨多种进路激光治疗喉内病变的临床效果，采用支撑喉镜，喉造口，以激光治疗喉腔内特殊病变１４例，包括先天性喉蹼、声带粘连、双侧喉返神经麻痹、复发性多发性喉乳头状瘤多次手术无效、喉外伤后甲状软骨及其内结构严重破坏以及继发感染伴喉腔大量肉芽生长及瘢痕形成者。随访至少观察６个月，１４例声嘶均得到不同程度改善；１３例呼吸恢复正常，另１例改用其他方法治愈。认为激光治疗喉病变具有其他手术方法所不具备的优越性。喉造口是治疗复发性多发性喉乳头状瘤及严重喉外伤喉腔大量肉芽生长的好方法，但术后必须观察２～３个月方可关闭喉腔。

ourteen patients with particular laryngopathies were treated by laser irradiation through self-retaining laryngoscope or laryngostomy approach. All cases were followed up for at least 6 months and the results were satisfactory. The laryngeal lesions included congenital laryngeal webs, adhension of vocal cord, bilateral recurrent laryngeal nerve paralysis, recurrent multiple papilloma of the larynx, extensive granulation and scar formation after laryngeal injuries and secondary infections. The hoarseness of all 14 cases was improved to a varying extent and the respiratory function of all cases returned to normal except one who was cured by other therapy. The results indicate that laser therapy has more advantages to other surgical managements, and laryngostomy may provide us a good approach for the treatment of recurrent multiple papilloma of the larynx and extensive grannulation after serious injuries of the larynx. However, the duration of postoperative observation should be lasted for 2-3 months before the laryngeal cavity is closed.