声门闭合不全性发声障碍的康复治疗

目的：探讨人胶原声带注射辅以发声训练治疗单侧声带固定和功能性声门闭合不全的疗效。方法：在强化局麻或静脉复合麻醉下，对5例单侧声带固定及4例功能性声门闭合不全患者经支撑喉镜进行人胶原声带注射，术后1周辅以发声训练。手术前、后对嗓音进行主观评估及声学分析。结果：6例患者术后声嘶明显改善，3例功能性声门闭合不全患者声嘶无改善。人胶原声带注射术后3个月频率微扰(Jitter)及振幅微扰(shimmer)下降，最大声时(MPT)延长，与术前比较，差异均有显著性意义；噪声能量(NNE)及谐噪比(H／N)的变化虽无统计学意义，但亦朝着有利于提高发声效率及质量的趋势发展。结论：人胶原声带注射辅以发声训练治疗单侧声带固定是简单、安全及有效的方法，但对于功能性声门闭合不全患者的疗效欠佳，有待进一步研究。

Clinic application of human collagen in the treatment of unilateral immobile vocal cord and functional glottic insufficiency

Objective To explore the clinic eff ec t of human collagen injected into vocal cord combined with vocalization training in treating unilateral immobile vocal cord and functional glottic insufficiency . Methods Five patients with unilateral immobile vo cal cord and 4 with functional glottic insufficiency were recruited in this stud y. Injection of the human collagen was performed by using sustained laryngoscope under general or topical anesthesia; vocalization training was done after 1 wee k of the operation. Voice was evaluated by subjective perception and acoustic an alysis before and after operation. Results After ope ration, hoarseness was obviously improved in 6 patients, but not in the other 3 patients with functional glottic insufficiency. Jitter and Shimmer descended, an d MPT increased after operation. All the above changes had statistic significanc e. NNE and H/N were also improved. Conclusion It is simple, safe and effective to use the human collagen injection into vocal cord in combination with vocalization training to treat unilateral immobile vocal c ord. But it might not be justifiable for the treatment of functional glottic ins ufficiency, as indicated by this study.