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目的探讨颈侧进路喉外单侧杓状软骨次全切除术应用于双侧外展性声带麻痹的手术方法及疗效。方法分析双侧外展性声带麻痹患者3例,其中甲状腺术后2例,不明原因1例。术中行喉外单侧杓状软骨次全切除,向外拉开声带,在支撑喉镜下观察到单侧声带外移,声门裂约5 mm。结果手术过程均顺利,2例患者术后2个月拔管,1例患者术后18 d拔管,随访6～32个月,声门裂仍约为5 mm,呼吸和发音满意。结论该手术术后喉功能恢复快而满意,是治疗双侧外展性声带麻痹的较好术式。
Objective To investigate the surgical approach and curative effect of sub lateral arytenoid cartilage subtotal laryngeal approach for bilateral abduction vocal cord paralysis. Methods Three cases of bilateral abduction vocal cord paralysis were analyzed, including 2 cases after thyroid surgery and 1 case with unknown cause. Intraoperative laryngeal unilateral arytenoid cartilage subtotal excision, the vocal cord was pulled out, the unilateral vocal cord was observed under the support laryngoscope, glottis crack about 5 mm. Results The operation was successful. Two patients were extubated 2 months after operation. One patient was extubated 18 days after operation. The follow-up ranged from 6 to 32 months. The prevalence of glottis was still about 5 mm. Respiration and vocalization were satisfactory. Conclusions The laryngeal function recovered quickly and satisfactorily after operation, which is a better technique for the treatment of bilateral abduction vocal cord paralysis.