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目的:探讨CO2激光杓状软骨声带突切除与肌腱切断治疗双侧声带外展麻痹的应用价值。方法:回顾性分析18例因甲状腺切除术后双侧声带外展麻痹的临床资料,术前预防性气管切开后,行CO2激光杓状软骨声带突切除与肌腱切断术。结果:18例患者术后即可经口鼻呼吸,其中15例于术后8周内拔管;3例于术后4～6周因局部肉芽组织增生再次激光手术后拔管;所有患者随访1.6～2.3年,无呼吸困难及误吸,对发声满意。结论:CO2激光杓状软骨声带突切除与肌腱切断,可有效改善双侧声带外展麻痹造成的呼吸困难,并取得较满意的发声,以及避免误吸。
OBJECTIVE: To investigate the value of subtotal cataract extraction and tendon incision in the treatment of bilateral vocal cord abduction with CO2 laser arytenoid cartilage. Methods: The clinical data of 18 patients with bilateral vocal cord abduction after thyroidectomy were analyzed retrospectively. After preoperative prophylactic tracheotomy, the C-wave laser aryteno-oophorectomy and tendon resection were performed. RESULTS: Twenty-eight patients were able to breathe through the nose and mouth postoperatively, of which 15 were extubated within 8 weeks after operation, 3 were extubated after laser surgery due to local granulation tissue hyperplasia 4 to 6 weeks after operation, and all patients were followed up 1.6 ~ 2.3 years, no breathing difficulties and aspiration, sound satisfactory. CONCLUSIONS: Cochlear ablation and tendon resection of the CO2 laser arytenoid cartilage can effectively improve the dyspnea caused by bilateral vocal cord abduction paralysis and achieve satisfactory vocalization and avoid aspiration.