声带沟的手术治疗

目的探讨声带沟的手术修复手段,以提高疗效.方法对经喉动态镜检查确诊的26例声带沟患者,采用喉显微外科手术加嗓音训练的综合方法治疗.其中单纯声带沟切除术9例,黏膜微瓣整复术11例,自体阔筋膜加脂肪声带注射术4例,阔筋膜声带植入术2例.术后10天进行嗓音训练,持续4～6个月.所有患者术前、术后定期行喉动态镜检查及嗓音学分析.结果术后仍有5例患者症状无明显改善,总有效率为80.8%(21/26).有效病例术后1周喉动态镜检查显示声带形态基本恢复正常,声带沟消失;术后1个月声带振动恢复.术后3个月嗓音声学分析显示声学参数较术前明显改善.行自体阔筋膜加脂肪声带注射术和阔筋膜声带植入术的6例患者中,最长观察时间28个月,声带黏膜波动良好.未出现任何并发症.结论喉显微外科手术加嗓音训练的综合治疗方法治疗声带沟效果满意.

Microphonosurgery of vocal sulcus

OBJECTIVE To study the effect of microphonosurgery in the treatment of vocal sulcus. METHODS Twenty-six patients with vocal sulcus were treated with microphonosurgery and speech therapy. The operative methods included simple incision, mucosal microflap repair, injection of fat and fascia lata, fascia lata implantation and the case number receiving above treatment was 9, 11, 4 and 2 respectively. Speech therapy was indispensable following microphonosurgery for 4 to 6 months. RESULTS The total effective rate was 80.8 % (21 of 26 cases) . Strobolaryngoscope examination showed that the morphology of vocal cord recovered approximately 1 week and the vibration returned to normal 1 month after surgery. Voice quality became better 3 months postoperatively. In all the 6 cases repaired by injection and implantation, the absorption of tissues was not detected. CONCLUSION The treatment of vocal sulcus with microphonosurgery and speech therapy can obtain satisfactory phonation effect.