喉结-声门偏斜的临床观察

目的探讨喉结－声门偏斜的临床特征及其机理。方法分析４５例喉结－声门偏斜病例的临床资料。结果男性占９７．８％，喉结偏右为８２．２％；８例声门不偏，其余前连合偏向与喉结一致；喉结偏向对侧、同侧及对照组的甲状软骨翼板横径依次为４．７±０．５ｃｍ、３．３±０．５ｃｍ及４．０±０．４ｃｍ，三组间差异极显著；翼板宽大侧有１９例伴上角肥厚。结论喉上神经－环甲肌－环甲关节－咽下缩肌（环－咽系统）为维持正常喉位主要因素，一侧环－咽系统功能亢进导致喉结－声门偏斜，偏向对侧的甲状软骨翼板增大及上角肥厚。上角肥厚所致喉上神经痛可经理疗及封闭控制。

Deviation of Prominentia Laryngea and Glottis: A Clinical Observation

Objective To explore the characteristics and the mechanism about deviation of the prominentia laryngea(PL) and the glottis. Methods The clinical data of 45patients with deviation of the PL and glottis were analysed. Results The male accounted for 97.2% and the PL deviated towards the right was found in 45 cases(82.2%). All the glottic anterior commissure, except 8 cases without the deviated glottis, was ipsilateral deflection with the PL. The transverse diameters of the lamina of thyroid cartilage(LTC), in opposition to the PL deviated, ipsilateral with the PL deviated and the contral group, were 4.70.5 cm, 3.30.5 cm and 4.00.4cm, respectively, The difference in three groups was obvious. The hypertrophic superior horn of the thyroid cartilage in 19 cases was all accompanied with the increased transverse diameter of the LTC. Conclusion The superior laryngeal nerve, cricothyreoideus, cricothyroid joint and inferior constrictor pharyngis(cricoid-pharyngeal system)are a main factor for keeping normal larynx location. Hyperfunction of unilateral cricoid-pharyngeal system led to deviation of the PL and the glottis and the increased transverse diameter of the LTC opposite to the deviated PL. Neuralgia occured when superior laryngeal nerve was pressed by the hypertrophic superior horn, the symptom of which could be controlled by local block therapy and physiotherapy.