声带麻痹（附155例分析）

目的提高对声带麻痹病因及临床表现的认识。方法分析了1989～1998年间155例声带麻痹的病因、症状、体征及电视频闪动态喉镜表现。随访3个月～10年。结果以原因不明63例（43．65％），有感冒史29例（18．71％）及甲状腺手术史27例（17．42％）为最常见。双侧声带麻痹6例，其中双声带位于旁正中位3例、2例位于中间位及1例左声带位于中间位而右侧位于旁正中位；单侧声带麻痹149例，其中左侧95例及右侧54例。声带完全性麻痹147例，不完全麻痹8例。仅46例得以随访。其中4例死于原发恶性肿瘤；7例声音恢复正常；5例声带中间位固定者声音略有改善；27例声带旁正中位固定者，有24例健侧声带代偿性过中线与3例患侧声带形成代偿性鼻肉样变而使声门闭合不全得以改善；及3例双侧声带旁正中位固定而行气管切开术。结论声带麻痹有多种原因，麻痹声带的位置对预后有影响。

Vocal cord Paralysis(Report of 155 cases)

Objectives To recognize the etiology and clinical presentation of vocal cord paralysis.Methods 155 cases of vocal cord paralysis were analyzed with etiology,symptoms, signs and videostrobolaryngoscopy from 1989 to 1996. A following period was from 3 months to 10 years.Results In etiology,it is the most common in uncertain causes (63 cases, 43. 65 % ),common cold (29 cases, 18. 71 % )and the secondary to thyroid surgery (27 cases, 17. 42% ). 6 cases had bilateral paralysis, in 3 cases of which the bilateral vocal cord were located in a paramedian position,2 cases in the intermediate and 1 case the left in the intermediate and the right in the paramedian.149 cases had unilateral paralysis(95 cases on left side and 54 on the right). There were 147 cases of complete paralysis and 8 cases of incomplete. Only were 46 cases followed up. 4 cases died of the primary malignant tumor, 7 cases recovered normal voice. Tracheotomy was applied for 3 cases with bilateral paramedia paralysis because of dyspnea. The hoarseness had improved in 5 cases having intermediate paralysis. In 27 cases with paramedian paralysis, the opposite vocal cord had overcompensation in 24 cases, and 3 cases had compensation polypoid changes, which helped to close glottic chink.Conclusions Vocal cord paralysis had many causes. The prognosis was different from the position of vocal cord paralysis.