一例甲状腺癌术后双侧声带完全性麻痹的治疗

Treatment of bilateral complete vocal cord paralysis after thyroidectomy

目的报道甲状腺癌术后双侧声带麻痹的治疗方案。方法对1例甲状腺癌术后声音嘶哑,进食梗阻,咽部异物感,干咳不适,双侧声带完全性麻痹,喉阻塞Ⅱ度的患者采取手术治疗的方案改善患者的声音嘶哑、吞咽梗阻、呼吸困难状况。结果此患者术后第2d予更换气管导管,术后第4d尝试堵管、试发声,患者恢复可,无呼吸、无吞咽困难予出院。术后3月返院复查喉镜,连续堵管48h无呼吸困难,无特殊不适予拔管。随访1年,声嘶有明显改善,未再出现进食梗阻、咽部异物感、干咳不适,日常生活及轻度运动无呼吸困难。结论对甲状腺癌术后双侧声带完全性麻痹的患者行显微支撑喉镜激光声门扩大术简单易行、创伤小,患者术后恢复快,能改善声音嘶哑、进食梗阻、咽部异物感,并有效改善呼吸功能。

Objective To report the treatment of bilateral vocal cord paralysis after thyroidectomy.Methods One case of thyroid cancer with hoarseness,eating obstruction,foreign body sensation in pharynx,dry cough discomfort,complete paralysis of bilateral vocal cords and second degree laryngeal obstruction was treated by operation to improve the status of hoarseness,swallowing obstruction and dyspnea.Results The tracheal tube was replaced on the second day after the operation,and the tube was blocked and the voice was made on the fourth day after the operation.The patient recovered without breathing or dysphagia.Three months after the operation,he returned to the hospital for reexamination of laryngoscope.After 48 hours of continuous tube plugging,he had no dyspnea and no special discomfort.After 1 year follow-up,the hoarseness was obviously improved,no eating obstruction,pharyngeal foreign body sensation,dry cough discomfort,no dyspnea in daily life and mild exercise.Conclusion Microsupport laryngoscope laser glottis enlargement is simple and easy for patients with complete paralysis of bilateral vocal cords after operation of thyroid cancer.It can improve hoarseness,eating obstruction,pharyngeal foreign body sensation and respiratory function.