声带脂肪注射术联合CO_(2)激光治疗单侧声带麻痹的临床疗效及对患者嗓音功能影响分析

Clinical effect of vocal cord fat injection combined with CO_(2) laser on unilateral vocal cord paralysis and its influence on voice function

目的:分析声带脂肪注射术联合CO_(2)激光改善单侧声带麻痹嗓音功能的疗效。方法:选定2021年12月至2023年2月在柳州市工人医院耳鼻喉科就诊的106例单侧声带麻痹患者,根据治疗方法不同分为对照组和观察组,每组53例。对照组给予CO_(2)激光切除麻痹侧的部分杓状软骨,观察组在对照组基础上给予声带脂肪注射术治疗。比较两组声门裂隙、麻痹侧声带表面积、嗓音声学参数、嗓音嘶哑程度(GRBAS)量表评分、嗓音障碍指数量表(VHI-10)评分、动态喉镜指标评分、并发症总发生率。结果:治疗前,两组各项指标比较,差异均无统计学意义(均P>0.05)。治疗后,观察组声门裂隙、标准化噪音能量(NNE)、振幅微扰(Shimmer)、频率微扰(Jitter)、GRBAS评分、VHI-10评分、声带振动规律性、声带运动对称性、声带黏膜波、声带闭合评分均低于对照组,最长发声时间(MPT)和麻痹侧声带表面积均高于对照组(均P<0.05)。观察组和对照组并发症总发生率(3.77%vs.5.66%)比较,差异无统计学意义(P>0.05)。结论:声带脂肪注射术联合CO_(2)激光可有效改善单侧声带麻痹患者嗓音功能,且未增加并发症的发生。

Objective:To analyze the effect of vocal cord fat injection combined with CO_(2) laser on improving vocal function of unilateral vocal cord paralysis.Methods:A total of 106 patients with unilateral vocal cord paralysis treated in Liuzhou Workers’Hospital from December 2021 to February 2023 were selected and divided into control group and observation group according to different treatment methods,with 53 cases in each group.The control group was treated with CO_(2) laser resection of arytenoid cartilage on the paralyzed side,and the observation group was treated with vocal cord fat injection on the basis of the control group.The glottic fissure,the surface area of the paralyzed vocal cord,voice acoustic parameters,the grade,roughness,breathiness,asthenia and strain(GRBAS)scale score,Voice Handicap Index-10(VHI-10)score,dynamic laryngoscopy index score and total complication rate were compared between the two groups.Results:There was no significant difference between the observation group and the control group before treatment(all P>0.05).After treatment,the glottic fissure,standardized noise energy(NNE),amplitude perturbation(Shimmer),frequency perturbation(Jitter),GRBAS score,VHI-10 score,vocal cord vibration regularity,vocal cord motion symmetry,vocal cord mucosal wave and vocal cord closure scores in the observation group were lower than those in the control group.However,the maximum vocal time(MPT)and the surface area of the paralyzed vocal cord were higher than those of the control group(all P<0.05).There was no significant difference in the total complication rate between the observation group and the control group(3.77%vs.5.66%)(P>0.05).Conclusion:Vocal cord fat injection combined with CO_(2) laser can effectively improve vocal function in patients with unilateral vocal cord paralysis without increasing the incidence of complications.