经环甲膜注射自体脂肪治疗单侧声带麻痹

autogenous fat injection into paralytic vocal fold through cricothyroid membrane to cure the unilateral glottic paralysis

目的:研究单侧麻痹声带经环甲膜注射脂肪后对患者嗓音改善的疗效。材料和方法:8例患者(女性5例,男性3例)患有单侧声带麻痹,5例为右侧,3例为左侧,行环甲膜穿刺声门下自体脂肪注射术。其中3例为全麻下手术,5例为纤维喉镜下局麻操作。随访6月～1年,患者对自己嗓音进行评价。结果:8例患者,术中所有患者均有注射脂肪的少量局部溢出。术后一周纤维喉镜检查均有注射侧的声带和室带的充血肿胀,2周后缓解。术后患者发音用力均减少,嗓音质量改善的6人,其中1例,在术后7个月时,嗓音质量下降,另1例术后1年后嗓音质量下降。较手术后1月时发音较费力,1例行注射后未有效随诊,1例没有要求再次注射。其余6例随诊期间无发音力量的明显减低。结论:经环甲膜声门下注射自体脂肪治疗单侧声带麻痹引起的发音力弱的方法简单易行,疗效较好。

Objective: To investigate the voice after autogenous fat injection into unilateral paralysis vocal cord through cricothyroid membrane.Material and method: Eight patients who had gotten unilateral vocal cord paralysis for more than 6 months were injected with autogenous fat into subglottis of paralytic vocal cord through cricothyroid membrane. Five patients were operated under the general anesthesia and endoscope,three under local anesthesia and fiberscope. All of patients followed up 6～12 months. Results: The fat overflowed during operation and congestive tumefaction occured in injected vocal cord for one week after surgery in all patients. Voice asthenia decreased after surgery in all patients and quality of voice improved in 6 patients. Voice quality deteriorated after surgery 7 months and vocal cord was injected again in one patient. One patient gave up the treatment after voice quality deteriorating. Others patients kept the voice after surgery.Conclusion: The Voice can be improved after autogenous fat injected into paralytic vocal fold through cricothyroid membrane.