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

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。

CO2 laser tenotomy and vocal process resection for treatment of bilateral vocal cord paralysis

Objective: To explore the clinical value of the treatment of bilateral vocal cord paralysis by tenoto-my and vocal process resection with CO_2 laser. Method: Eighteen cases of bilateral vocal cord paralysis after thy-roidectomy from March 2004 to June 2006 were retrospectively analyzed. Preoperative tracheotomy and CO_2 laser tenotomy and vocal process resection were performed. Result: All patients were able to breathe through the mouth and nose immediately after the operation. Fifteen patients were extubated within 8 weeks. Three patients were op-erated again after 4-6 weeks because of granulation hyperblastosis. All patients were followed up for 1. 6 years to 2. 3 years without breathing difficulties, aspiration and with satisfactory voice. Conclusion: The approach of CO_2 la-ser tenotomy and vocal process resection can effectively relieve breathing difficulty resulted from bilateral vocal cord paralysis, achieve satisfactory voice and avoid aspiration.