双声带楔形切除术治疗双侧声带外展麻痹

目的：探讨治疗双侧声带外展麻痹的微创外科手术方式——显微支撑喉镜下CO2激光双声带楔形切除术的临床应用价值。方法：使用显微支撑喉镜激光手术系统，治疗4例双侧声带外展麻痹患者。结果：3例经过1次手术，1例经过2次手术，随访5-36个月，患者呼吸困难完全缓解，能耐受日常生活活动；4例均对自己的声音较为满意，能进行日常的生活交流。结论：显微支撑喉镜CO2激光双侧声带楔形切除术，不需气管切开，术后喉功能恢复快，并发症少。既能解决患者通气的要求，又能保证发声的质量，本方法治疗双侧声带外展麻痹有很好的临床推广使用价值。

Bilateral wede-shaped cordectomy for treatment of bilateral vocal cord paralysis

OBJECTIVE: A clinical evaluation of CO2 laser endoscopic bilateral posterior wedge-shaped cordectomy (EBPC) in patients with severely compromised airway due to bilateral paralysis of the vocal fold. METHOD: The CO2 laser EBPC was performed in four cases of bilateral vocal cord paralysis. Follow-up has ranged from five months to 36 months. RESULT: Three patients achieved satisfactory airway after one laser procedure and one patient received second laser operation to manage her posterior webbing. Final voice quality was subjectively good in all patients. CONCLUSION: The authors' data confirm the safety, ease of performance, and efficiency of the CO2 laser EBPC in patients with bilateral vocal fold paralysis. The advantages of the procedure are simplicity in concept, reliability of outcome, no need for prophylactic tracheotomy, low risk of complications, adequate airway and good voice preservation. CO2 laser endoscopic bilateral posterior wedge-shaped cordotomy is an alternative management option for relief of upper airway obstruction due to bilateral vocal cord paralysis in abduction. The procedure is worthy to apply in clinical use.