支撑喉镜下CO_2激光分离联合硅胶膜置入治疗继发性声带粘连

Use of Suspension Laryngoscopy CO_2 Laser Combined with Placement of Silastic Keel for the Treatment of the Vocal Cords Adhesion

王燕;屈季宁;周涛;明伟;

1:武汉大学人民医院耳鼻咽喉-头颈外科

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摘要

目的探讨支撑喉镜下应用CO_2激光分离切除声带蹼样粘连后置入硅胶膜治疗继发性声带粘连的临床疗效。方法以21例继发性声带粘连的成年患者为研究对象,其中,发生于双侧声带任克水肿、声带小结、声带息肉、声带白斑手术后16例,喉乳头状瘤手术后4例,喉部外伤导致声带粘连1例,粘连范围均为声带前1/31/2;均在支撑喉镜下应用CO_2激光分离并切除声带前部正中粘连带后,置入的硅胶膜使其隔离声门前端分离的创面并经喉内、外联合进路缝合固定于颈前皮肤;术后3周取出硅胶膜,随访半年,观察疗效。结果 20例患者术后3周顺利取出硅胶膜,1例患者术后2周因颈部软组织感染取出硅胶膜后痊愈;术后随访6个月,除1例患者再次发生声带前联合粘连外,其余20例患者声带前联合均获得良好三角形形态,无瘢痕及肉芽形成,声嘶均明显改善。结论支撑喉镜下CO_2激光分离联合硅胶膜置入隔离创面3周治疗声带粘连,创伤小,效果好,并发症少。

关键词

声带粘连;CO2激光;硅胶膜

基金项目(Foundation):

作者

王燕;屈季宁;周涛;明伟;

参考文献

1 Matrka L,Simpson CB.Anterior glottic webs[J].Operative Techniques in Otolaryngology,2012,23:111.

2 Hsiao TY.Combined endolaryngeal and external approaches for iatrogenic glottic web[J].Laryngoscope,1999,109:1347.

3 Stasney CR.Laryngeal web:a new treatment for an old problem[J].Journal of Voice,1995,9:106.

4 Beswick DM,Clark AK,Bergeron J,et al.Endoscopic suture retriever for endolaryngeal keel placement in treatment of anterior glottic webs[J].Annals of Otology Rhinology&Laryngology,2015,124:240.

5 Benmansour N,Remacle M,Matar N,et al.Endoscopic treatment of anterior glottic webs according to Lichtenberger technique and results on 18patients[J].European Archives of Oto-Rhino-Laryngology,2012,269:2075.

6 Edwards J,Tanna N,Bielamowicz SA.Endoscopic lysis of anterior glottic webs and silicone keel placement[J].Annals of Otology Rhinology&Laryngology,2007,116:211.

7 Paniello RC,Desai SC,Allen CT,et al.Endoscopic keel placement to treat and prevent anterior glottic webs[J].Annals of Otology Rhinology&Laryngology,2013,122:672.

8 Garrel R,Amy de La Bretèque B,Canitrot L,et al.Onestep microsurgery for acquired anterior glottis web[J].European Annals of Otorhinolaryngology,Head and Neck diseases,2012,129:e61.

9 Schweinfurth J.Single-stage stentless endoscopic repair of anterior glottis webs[J].Laryngoscope,2002,112:933.

10 Hirano M.Psycho-acoustic evaluation of voice:GRBAS scale for evaluating the hoarse voice.In:Hirano M,ed.Clinical examination of voice[M].Wien,New York:SpringerVerlag,1981.81~84.

11 蔡红武,唐安洲,徐志文,等.喉CO2激光手术后声带粘连原因分析[J].临床耳鼻咽喉头颈外科杂志,20l0,24:147.

12 Roh JL,Yoon YH.Prevention of anterior glottic stenosis after transoral microresection of glottic lesions involving the anterior commissure with mitomycin C[J].Laryngoscope,2005,115:1055.

13 Fang R,Sun J,Wan G,et al.Comparison between mitomycin C and chitosan for prevention of anterior glottic steno after CO2laser cordectomy in dogs[J].Laryngoscope,2007,117:2057.

14 Kwon SK,Ryu YJ,Kim DW,et al.Prevention of anterior glottis web with hyaluronic acid derivatives in rabbit model[J].Laryngoscope,2016,doi:10.1002/lary.26089.

15 Paniello RC,Desai SC,Allen CT,et al.Endoscopic keel placement to treat and prevent anterior glottic webs[J].Annals of Otology Rhinology&Laryngology,2013,122:672.

16 Cheng AT,Beckenham EJ.Congenital anterior glottic webs with subglottic stenosis:surgery using perichondrial keels[J].International Journal of Pediatric Otorhinolaryngology,2009,73:945.

17 徐文,韩德民,李红艳,等.支撑喉镜下喉硅胶膜置入及声带缝合手术治疗喉蹼[J].中华耳鼻咽喉头颈外科杂志,2007,42:581.

18 魏春生,陈琦,张天宇.应用Liehtenberger喉镜内缝合器固定硅胶膜治疗声门型喉蹼[J].听力学及言语疾病杂志,2010,18:179.

19 Liyanage SH,Khemani S,Lloyd S,et al.Simple keel fixation technique for endoscopic repair of anterior glottic stenosis[J].Journal of Laryngology&Otology,2006,120:322.

20 陈浩,孙敬武,万光伦.支撑喉镜下硅胶膜置入治疗喉蹼[J].听力学及言语疾病杂志,2013,21:255.

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声带粘连 CO2激光硅胶膜

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王燕屈季宁周涛明伟