155例声带麻痹患者的临床分析

Clinical Evaluation of 155 Patients with Vocal Fold Paralysis

牛燕燕;倪道凤;

1:中国医学科学院北京协和医学院北京协和医院耳鼻咽喉头颈外科

摘要
目的了解声带麻痹的病因和临床特点。方法回顾性分析155例声带麻痹患者的临床资料。结果 155例声带麻痹患者中首诊于耳鼻喉科91例(58.71%),左侧78例,右侧33例,双侧44例,左、右侧差异有统计学意义(P<0.05);声带固定于旁正中位124例(80%);声带完全麻痹116例(74.84%);单侧声带麻痹均因不同程度声音嘶哑就诊,双侧声带麻痹因声音嘶哑、呛咳和呼吸困难就诊,双侧声带不完全麻痹均因II度以上呼吸困难就诊;病因以医源性损伤占首位,共72例(46.45%),其次为喉外肿瘤及占位性病变,共37例(23.87%),特发性病因23例(14.84%),其他原因23例(14.84%)。结论单、双侧声带完全麻痹者以声嘶为主要症状,双侧声带不全麻痹者以呼吸困难为主要症状,体征多样,病因复杂,以医源性损伤、喉外肿瘤及占位性病变为多见。
关键词
声带麻痹;病因;嗓音
基金项目(Foundation):
作者
牛燕燕;倪道凤;
参考文献

1 Myssiorek D.Recurrent laryngeal nerve paralysis:Anatomyand etiology[J].Otolaryngol Clin N Am,2004,37:25.

2 Collazo-Clavell ML,Gharib H,Maragos NE.Relationshipbetween vocal cord paralysis and benign thyroid disease[J].Head Neck,1995,17:24.

3 Yumoto E,Minoda R,Hyodo M,et al.Causes of recurrentlaryngeal nerve paralysis[J].Auris Nasus Larynx,2002,29:41.

4 Weisberg NK,Spengler DM,Netterville JL.Stretch-inducednerve injury as a cause of paralysis secondary to the anteriorcervical approach[J].Otolaryngol Head Neck Surg,1997,116:317.

5 Dedo HH.The paralyzedlarynx:an electromyographic studyindogs and humans[J].Laryngoscope,1970,80:1 455.

6 Kouf man JA,Walker FO,Joharji GM.The cricothyroid mus-cle does not influence vocal cord positioninlaryngeal paralysis [J].Laryngoscope,1995,105:368.

7 Tanaka S,Hirano M,Chui wa K.Some aspects of vocal foldbowing[J].Ann Otol Rhinol Laryngol,1994,103:357.

8 Sataloff RT.Professional voice:the science and art of clinicalcare.3rd edition[J].San Diego(CA):Plural Publishing,Inc.2006.871~876.

9 Netterville JL,Kori wchak MJ,Winkle M,et al.Vocal foldparalysis following the anterior approach to the cervical spine[J].Ann Otol Rhinol Laryngol,1996,105:85.

10 Sturniolo G,D'alia C,Tonante A,et al.The recurrent laryn-geal nerve related to thyroid surgery[J].AmJ Surg,1999,77:485.

11 Eltzschig HK,Posner M,Moore FDJr.The use of readily a-vailable equipment in a si mple method for intraoperative mo-nitoring of recurrent laryngeal nerve function during thyroidsurgery:Initial experience with more than 300 cases[J].Arch Surg,2002,137:452.

12 Friedrich T,Staemmler A,Hansch U,et al.Intraoperativeelectrophysiological monitoring of the recurrent laryngealnerveinthyroid gland surgery-a prospective study[J].Zen-tralbl Chir,2002,127:414.

13 Benninger MS,Gillen JB,Alt man JS.Changing etiology ofvocal foldi mmobility[J].Laryngoscope,1998,108:1 346.

14 Srirompotong S,Sae-Seow P,Srirompotong S.The causeand evaluation of unilateral vocal cord paralysis[J].J MedAssoc Thai,2001,84:855.

15 Tucker HM.Rehabilitation of the i mmobile vocal fold:Pa-ralysis and/or fixation[M].In:Fried MP,ed.The larynx:A multidisciplinary approach.2nd edition.St.Louis:Mos-by;1996.209~219.

16 Bachor E,Bonkowsky V,Hacki T.Herpes si mplex virustype I reactivation as a cause of a unilateral temporary paraly-sis of the vagus nerve[J].Eur Arch Otorhinolaryngol,1996,253:297.

17 Nishizaki K,Onoda K,Akagi H,et al.Laryngeal zosterwith unilateral laryngeal paralysis[J].ORL J Otothinolaryn-gol Relat Spec,1997,59:235.

18 Johns MM,Hogikyan ND.Si multaneous vocal fold and tongueparesis secondary to Epstein-Barr virusinfection[J].Arch Oto-laryngol Head Neck Surg,2000,126:1 491.

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声带麻痹病因嗓音

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牛燕燕倪道凤