| 摘要: |
| 目的:观察自制可调式钛钉支架植入治疗犬单侧声带麻痹的疗效及预后。方法:自行设计制备可调式钛钉支架。Beagle犬随机分为实验组和对照组（n=3）：实验组犬切断左侧喉返神经后，行可调式钛钉支架植入术，将左侧杓状软骨内移内收使左声带位于正中位，达到发音时声门闭合；对照组犬左喉返神经切断后不再行其他手术。术前、术后即刻及术后1、2、4个月对各组犬进行喉镜观察，术后即刻及术后1、2、4个月对各组犬行喉CT及喉部组织病理学检查，随访观察治疗效果及预后。结果:术后4个月，喉镜发现实验组可调式钛钉支架植入能使犬左侧杓状软骨内移内收，有利声门闭合，提高发音质量；对照组左声带位于旁中位，发音时声门有缝隙。喉CT示实验组钛钉支架植入位置良好，固定无脱落。术后1、2、4个月实验组、对照组犬喉标本病理学检查见局部早期轻微炎症，喉内肌萎缩随时间延长而明显；实验组未见植入物周围组织严重感染、植入物排出等现象。结论:自制可调式钛钉支架植入治疗犬单侧声带麻痹手术简便，术中可调性强且可即时观察，近期疗效可，值得深入研究以推广使用。 |
| 关键词: 钛钉 喉支架术 人工喉 声带麻痹 |
| DOI：10.3724/SP.J.1008.2009.01145 |
| 投稿时间：2009-03-01修订日期：2009-09-04 |
| 基金项目: |
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| Self-designed adjustable titanium screw in treatment of unilateral vocal cord paralysis:an observation of curative effects |
| WEN Wu1,SUN Bi-feng1*,LIU Chang1,ZHANG Ming-xing1,YU Yong-wei2 |
| (1.Department of Otorhinlaryngology,Changhai Hospital,Second Military Medical University,Shanghai 200433,China;2.Department of Pathology,Changhai Hospital,Second Military Medical University,Shanghai 200433) |
| Abstract: |
| Objective:To observe the curative effects of self-designed adjustable titanium screw in treatment of unilateral vocal cord paralysis in dogs.Methods: We designed and prepared an adjustable titanium screw.The beagle dogs were divided into an experimental group and a control group (n=3) at random.Animals in the experimental group had their left recurrent laryngeal nerve resected and received implantation of adjustable titanium screw.The left arytenoid cartilage was adjusted to allow the left vocal cord in the middle,so as to achieve glottis closure when making a sound.The dogs in the control group only received recurrent laryngeal nerve resection.Observation with electron fibrolaryngoscope and CT was done immediately,1,2,and 4 months after operation; electron fibrolaryngoscope was also used before operation.The curative effects and the prognoses of dogs were observed.Results: Four months after operation electron fibrolaryngoscope found that the adjustable screw in the experimental group could make the left arytenoid cartilage move inwardly,benefiting glottis closure and improving the voice quality.Animals in the control group had their left vocal cord located in the paramedina position,and there was cleft during glottis closure.CT image indicated that the adjustable screw was in a good position,and there was no breaking off.Local slight inflammation was seen in both groups 1,2,and 4 moths after operation.Tntrinsic laryngeal muscle atrophy aggravated as time passing by.There was no severe inflammation around the implants or implants excretion.Conclusion: Our adjustable screw is easy to perform in surgical treatment of unilateral vocal cord paralysis; it can be adjusted during operation and the outcome can be observed in time.The short-time effect is confirmed and the method is worth popularizing. |
| Key words: titanium screw thyroplasty artificial larynx vocal cord paralysis |
