鼻内镜联合支撑喉镜切除声门暴露困难的声带息肉

Nasal Endoscopy Combined with Self-retaining Laryngoscopy for Vocal Cord Polyps in Difficult Laryngeal Exposure

目的探讨鼻内镜联合支撑喉镜切除声门暴露困难的声带息肉的疗效。方法 2006年6月～2009年7月支撑喉镜直接暴露声门困难26例,7例位于声带前联合处,19例位于声带前1/3处,联合使用鼻内镜,通过调整鼻内镜角度及旋转视野达到完全显露声带全程,切除声带息肉。结果 4例术后第2天发观轻度咽部擦伤,对症处理后擦伤消退。无门齿脱落、颈椎损伤、舌体损伤等严重并发症。26例随访6～12个月,平均9个月,23例在术后1周达到治愈标准,余3例进一步治疗后治愈。结论鼻内镜联合支撑喉镜下手术,适用于颈部粗短、颈部活动受限、喉体较高患者,对声门暴露困难的声带息肉切除疗效满意。

Objective To investigate the efficacy of self-retaining laryngoscope combined with nasal endoscope for vocal cord polyps in difficult laryngeal exposure.Methods We selected 26 patients who had received endoscopic surgery combined with self-retaining laryngoscopy for vocal cord polyps between June 2006 and July 2009.All the cases had difficulty in exposing the laryngeal.Among the cases,7 had the lesion at the anterior vocal commissure,and the other 19 had polyp at the anterior 1/3 of the vocal cord.Results After the operation,4 patients showed mild pharyngeal scratches and then was cured by symptomatic treatment.No severe complications,including injuries to the incisor teeth,cervical vertebra or tongue,occurred.The patients were followed up for 6 to 12 months with a mean of 9 months,23 of them were cured in one week after the operation,and the other 3 were cured after further treatments.Conclusions Self-retaining laryngoscopy combined with nasal endoscopy is appropriate for patients with short neck and high larynx or limited cervical movement.It is effective for difficult laryngeal exposure.