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目的:探讨支撑喉镜下CO2激光行单侧杓状软骨内侧粘膜下部分切除术治疗双侧声带麻痹的疗效。方法:25例双侧声带麻痹患者分别采用CO2激光杓状软骨内侧粘膜下部分切除术(A组8例),喉外径路声带外移固定术(B组17例)治疗,手术前后行声门测量及嗓音分析。结果:A、B两组拔管率分别为88.00%(7/8)76.74%(13/17),术后A组最大开放声门面积及声门后部最大横径明显大于B组,差异具有统计学意义。A组术后7例能保持术前的嗓音质量,1例下降;B组术后7例嗓音无变化,10例下降。结论:激光杓状软骨内侧粘膜下部分切除术简单易行,拔管率高,患者的呼吸和发音功能均得到满意的恢复和保留。
Objective: To investigate the effect of submachial radiofrequency ablation of unilateral arytenoid cartilage in the treatment of bilateral vocal cord paralysis with CO2 laryngoscope. Methods: Twenty-five patients with bilateral vocal cord paralysis underwent partial submucosal partial resection of the arytenoid cartilage (group A, n = 8), vocal cord laryngeal external fixation (group B, n = 17) Measurement and voice analysis. Results: The extubation rates of group A and B were 88.00% (7/8) and 76.74% (13/17) respectively. The maximum open glottic area and the maximum transverse diameter of the posterior glenoid in group A were significantly larger than those in group B has statistical significane. A group of 7 patients after surgery to maintain the voice quality, 1 case decreased; B group after 7 cases of no change in voice, 10 cases decreased. Conclusion: The submucosal resection of the medial arylarylary cartilage is simple and easy, and the rate of extubation is high. The respiration and phonation of the patients are both satisfactorily restored and preserved.