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題名 | 內視鏡二氧化碳雷射杓狀軟骨內側切除術--四例報告=Endoscopic Carbon Dioxide Laser Medial Arytenoidectomy--Roport of Four Cases |
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作者 | 朱英政; 陳彥銘; Chu, Ying-cheng; Chen, Yen-ming; |
期刊 | 中華民國耳鼻喉科醫學會雜誌 |
出版日期 | 19980600 |
卷期 | 33:3 1998.06[民87.06] |
頁次 | 頁70-75 |
分類號 | 416.89 |
語文 | chi |
關鍵詞 | 聲帶麻痺; 二氧化碳雷射; 杓狀軟骨內側切除術; Vocal cord paralysis; Carbon dioxide laser; Medial arytenoidectomy; |
中文摘要 | 兩側聲帶麻痺並非罕見,大部分患者會因為兩側聲帶停留在靠近中線位置且無法 外展而造成呼吸阻塞,但多數仍有相當好的聲音。治療的難題就在於如何在社交上有令人滿 意的聲音及日常生活活動中保持通暢的呼吸道間尋求一最佳的折衷點。內視鏡二氧化碳雷射 杓狀軟骨內側切除術治療,改良自杓狀軟骨切除術;為一打開後段聲門呼吸道之有效及方便 的方法。此過程只影響杓狀軟骨內側,然而聲門前三分之二的發聲區,後黏合處的黏膜及杓 狀肌皆保持完好。故手術後除了呼吸阻塞的情況能夠得到相當理想的改善之外,音聲也沒明 顯變壞的情形,亦無誤嗆或其他併發症的發生。對於兩側聲帶麻痺導致輕、中度呼吸道不足 之病人,內視鏡雷射杓狀軟骨內側切除術可說是理想治療選擇。 |
英文摘要 | Bilateral vocal cord paralysis is not uncommon. Most patients suffer from airway obstruction, due to the bilateral vocal cords positioned at the midline and were not able to abduct, but they still retain satisfactory voice quality. The difficulty in treatment lies in the compromise between satisfactory voice in social life and sufficient airway for ordinary activity. Endoscopic carbon dioxide laser medial arytenoidectomy modified from arytenoidectomy, is an effective and conventent method for enlarging the posterior one third of the glottis (respiratory portion). This procedure influences only in the medial side of arytenoid cartilage. The anterior two third of glottis (phonatory portion), mucosa over the posterior commissure and the arytenoid muscle all remain inatct. After the surgery, the airway obstruction was got much improvement, and no obvious disturbance in voice quality, no aspiration or other complications were noted. Hence, we can say that endoscopic carbon dioxide laser medial arytenoidectomy is the ideal choice for the treatment of the patients who suffered from mild or moderate degree of airway obstruction due to bilateral vocal cord paralysis. |
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