Nd:YAG激光对喉部良性病变的治疗作用

Nd：YAG激光经纤维喉长导入治疗喉部良性病变37例，其中声带息肉21例，喉乳头状瘤4例，声带小结4例，喉囊肿8例．结果，所有息肉、囊肿及小结均一次治愈，乳头状瘤一次彻底切除1例，经两次治疗根治2例，1例经四次手术方切净．术后发音有明显改善，无出血及呼吸困难，经过3年-5年观察，除经四次激光治疗的乳头状病患者复发，余各例均未见复发．结论：本方法具有以下优点：①不受颈短、颈强直、上切牙长、舌伸不出、张口困难、会反后倾、舌背高拱、咽反射敏感等影响；①视野大，照明好，分辨率高，便于区别正常组织与病变组织，对前联合及声门下病变的处理也较容易；③无须全麻，术后反应轻，恢复快、痛苦小，经济省时；④激光治疗对范围广泛的良性肿瘤也有良好效果，降低发发率，减轻副损伤．

Therapy of Laryngeal Benign Affection with Nd:YAG Laser

Thirty-seven cases of laryngeal benign affection were treated with Nd:YAG laser through fibral laryngoscope. There were 21 cases vocal polyps, 4 cases laryngeal papillomas, 4 cases vocal nodulus. 5 cases vocal cysts and 3 cases epiglottic cysts. All the patients with polyps, cysts and nodulus had cured after once treatment. One patient suffering from papilloma removed the tUmor through only once, 2 cases twice and 1 case through 4 times operation. Phonation of all the patients had improved clearly and without hemorrhage and dyspnea. Tracing examination 3 -- 5 years, all the pahents had no recurrence except the last one. Treatment of laryngeal benign affection with Nd(YAG laser conducted through fibral endoscope had some advantages as follows (l) LimiUess of short-neck, stiffneck, longerupper incisor, difficult of lingual extention and mouth opening, epiglottic retroversion aam sensitive phnyngeal reflex. (2) Wide visual field. bright, higher resolving power and easy to distinguish normal and abnormal tissue. At the same time, easier to treat the affection of anterior co~ssure aam infraglottic. (3) Needless general anesthesia, the patients have lighhy reaction and small soreness. The patients restored quickly and save the bine and cost. (4) adder therapy has better effect to extensive benign tumor, also avoid planting, reduce the recurrence rate and traumas.