声带沟的内镜图像形态特征及疗效分析

Study on Electronic Laryngoscopic Images of Sulcus Vocalis and Its Clinical Significance

目的探讨声带沟的电子喉镜图像形态特征、临床分型及治疗效果。方法对63例声带沟患者的电子喉镜图像、病史、临床表现、治疗方法及疗效进行回顾性分析和评价。结果电子喉镜检查显示63例患者的声带沟形态分别为裂线型37例(58.73%),生理型14例(22.22%),局凹型12例(19.05%);声门闭合形态为梭形裂隙36例(57.14%),线形裂隙18例(28.57%),闭合良好9例(14.29%);双侧声带沟48例(76.19%),单侧15例(23.81%)。生理型(Ⅰ型)声带沟14例(22.22%),病理型声带沟49例(77.78%),其中Ⅱ型37例(58.73%),Ⅲ型12例(19.05%)。63例中,7例(Ⅱ型5例、Ⅲ型2例)行自体筋膜充填术及自体脂肪注射术,随访19±3.3个月,均发声明显好转,电子喉镜检查示声带沟消失,声门闭合良好。结论电子喉镜下声带沟的形态以裂线形和局凹形为多见,声门闭合时大部分呈梭形裂隙;以双侧病理型多见,其中Ⅱ型声带沟最多;自体筋膜充填术及自体脂肪注射术是改善患者发声状况的有效方法之一。

Objective To study the electronic laryngoscopic imaging characteristics,clinical classification and treatment effect of sulcus vocalis.Methods Electronic laryngoscopic imaging characteristics,case histories,clinical manifestations and therapies were retrospectively analyzed and evaluated in 63cases of sulcus vocalis.Results The shapes of electronic laryngoscopic images of sulcus vocalis：37cases（58.73%）were groove crack shape,14cases（22.23%）were physiology shape,and 12cases（19.05%）were bureau concave.The glottal configuration during closing：36cases（57.14%）were with spindle-like cleft,18cases（28.57%）were with line-like cleft,9cases（14.29%）had no cleft.Vocal cord groove lesions involvement：48cases（76.19%）were bilateral sulcus vocalis,15cases（23.81%）were unilateral sulcus vocalis.Classification of sulcus vocalis：14cases（22.22%）were physiologic type（TypeⅠ）,49cases including typeⅡ37cases（58.73%）pathologic type and 12cases（19.05%）were typeⅢ.Seven cases（5cases of typeⅡ,2cases of typeⅢ）which treated by surgery of autologous fascia transplantation and autologous fat injection,with the follow-up visit more than 1year（median follow-up of 19±3.3months）,showed obvious improvement in phonation and sulcus vocalis disappeared with well closure function by the electronic laryngoscope.Conclusion The electronic laryngoscope demonstrated that there were groove crack shape,line crack shape and bureau concave on surface of vocal cord.And the spindle-like cleft glottal configuration was in the majority during glottis closing.The common type was bilateral pathological,most of them was typeⅡ.Autologous fascia transplantation and autologous fat injection were one of the effective methods for the improvement of pronunciation.