Clinical effect of vocal cord fat injection combined with CO2 laser on unilateral vocal cord paralysis and its influence on voice function
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摘要 目的：分析声带脂肪注射术联合CO2激光改善单侧声带麻痹嗓音功能的疗效。方法：选定2021年12月至2023年2月在柳州市工人医院耳鼻喉科就诊的106例单侧声带麻痹患者，根据治疗方法不同分为对照组和观察组，每组53例。对照组给予CO2激光切除麻痹侧的部分杓状软骨，观察组在对照组基础上给予声带脂肪注射术治疗。比较两组声门裂隙、麻痹侧声带表面积、嗓音声学参数、嗓音嘶哑程度（GRBAS）量表评分、嗓音障碍指数量表（VHI-10）评分、动态喉镜指标评分、并发症总发生率。结果：治疗前，两组各项指标比较，差异均无统计学意义（均P> 0.05）。治疗后，观察组声门裂隙、标准化噪音能量（NNE）、振幅微扰（Shimmer）、频率微扰（Jitter）、GRBAS 评分、VHI-10 评分、声带振动规律性、声带运动对称性、声带黏膜波、声带闭合评分均低于对照组，最长发声时间（MPT）和麻痹侧声带表面积均高于对照组（均P< 0.05）。观察组和对照组并发症总发生率（3.77%vs.5.66%）比较，差异无统计学意义（P> 0.05）。结论：声带脂肪注射术联合CO2激光可有效改善单侧声带麻痹患者嗓音功能，且未增加并发症的发生。Abstract Objective: To analyze the effect of vocal cord fat injection combined with CO2 laser on improving vo-cal function of unilateral vocal cord paralysis.Methods: A total of 106 patients with unilateral vocal cord paraly-sis treated in Liuzhou Workers’Hospital from December 2021 to February 2023 were selected and divided into control group and observation group according to different treatment methods, with 53 cases in each group.The control group was treated with CO2 laser resection of arytenoid cartilage on the paralyzed side, and the observa-tion group was treated with vocal cord fat injection on the basis of the control group.The glottic fissure, the sur-face area of the paralyzed vocal cord, voice acoustic parameters, the grade, roughness, breathiness, asthenia and strain(GRBAS)scale score, Voice Handicap Index-10(VHI-10)score, dynamic laryngoscopy index score and to-tal complication rate were compared between the two groups.Results: There was no significant difference be-tween the observation group and the control group before treatment (all P> 0.05).After treatment, the glottic fis-sure, standardized noise energy (NNE), amplitude perturbation (Shimmer), frequency perturbation (Jitter), GRBAS score, VHI-10 score, vocal cord vibration regularity, vocal cord motion symmetry, vocal cord mucosal wave and vocal cord closure scores in the observation group were lower than those in the control group.Howev-er, the maximum vocal time(MPT)and the surface area of the paralyzed vocal cord were higher than those of the control group (all P< 0.05).There was no significant difference in the total complication rate between the obser-vation group and the control group (3.77% vs. 5.66%) (P> 0.05).Conclusion: Vocal cord fat injection combined with CO2 laser can effectively improve vocal function in patients with unilateral vocal cord paralysis without in-creasing the incidence of complications.
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[1] OSCE H, MAGAMADOV K, VAN DEN HEEDE K, et al.Intra-operative recovery of preoperative vocal cord paraly-sis during hemithyroidectomy for benign thyroid disease:case report and review of the literature[J].Acta chirurgica belgica, 2021, 121(3):215-218.
[2] 邹冬蕾,刘鑫,庄珣,等.靳三针配合导气调神治疗甲状腺癌切除术后声带麻痹[J].中医药学报, 2022, 50(12):86-89. ZOU D L, LIU X, ZHUANG X, et al.Jin Sanjin com-bined with guiding Qi and regulating Shen to treat vocal paralysis after thyroidectomy[J].Chinese journal of medi-2022, 50(12):86-89.
[3] 胡蓉,徐文,林毓鸿,等.特发性单侧声带麻痹预后及喉肌电图特征分析[J].听力学及言语疾病杂志, 2021, 29(4):382-387. HU R, XU W, LIN Y H, et al.Prognosis of idiopathic uni-lateral vocal cord paralysis and analysis of laryngeal EMG cteristics[J].Journal of audiology and speech disorders, 2021, 29(4):382-387.
[4] 郭颖,王美熠,王敬东.CO2激光联合复方安息香酊雾化吸入治疗声带息肉的临床观察[J].中国激光医学杂志, 2020, 29(4):203-207. GUO Y, WANG M Y, WANG J D.Clinical observation of CO2 laser combined with compound benzoin tincture for treatment of vocal cord polyp[J].Chinese journal of laser medicine, 2020, 29(4):203-207.
[5] 台勇,吉昱姿,马季青,等.等离子射频消融术治疗老年早期声门型喉癌的远期疗效及其对嗓音声学影响[J].中国临床解剖学杂志, 2022, 40(2):216-220. TAI Y, JI Y Z, MA J Q, et al.Long-term effect of plasma radiofrequency ablation in the treatment of early glottic laryngeal cancer in elderly patients and its influence on voice acoustics[J].Chinese journal of clinical anatomy, 2022, 40(2):216-220.
[6] 任佳,杨慧,王海洋,等.内镜下A型肉毒素声带注射治疗内收型痉挛性发声障碍疗效评估[J].临床耳鼻咽喉头颈外科杂志, 2020, 34(11):1019-1023. REN J, YANG H, WANG H Y, et al.Evaluation of endoscopic botox A injection into vocal cord for the treatment of adductive spastic dysphonia[J].Journal of clinical otolaryngology, head and neck surgery, 2020, 34(11):1019-1023.
[7] 张海燕,任懿,徐伟.自体筋膜填充联合筋膜加脂肪声带内注射治疗声带沟39例远期疗效观察[J].中华耳鼻咽喉头颈外科杂志, 2021, 56(10):1080-1086. ZHANG H Y, REN Y, XU W.Long-term effect of autogenous fascia filling combined with fascia plus fat injection in the treatment of 39 cases of vocal cord furrows[J].Chinese journal of otolaryngology head and neck surgery, 2021, 56(10):1080-1086.
[8] 中华耳鼻咽喉头颈外科杂志编辑委员会咽喉组,中华医学会耳鼻咽喉头颈外科学分会咽喉学组,中华医学会耳鼻咽喉头颈外科学分会嗓音学组.声带麻痹诊断及治疗专家共识[J].中华耳鼻咽喉头颈外科杂志, 2021, 56(3):198-209. CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY EDITORIAL BOARD LARYNGOLOGY GROUP, CHINESE MEDICAL ASSOCIATION OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY SOCIETY, LARYNGOLOGY GROUP, CHINESE MEDICAL ASSOCIATION OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY SOCIETY.Expert consensus on diagnosis and treatment of vocal cord paralysis[J].Chinese journal of otolaryngology head and neck surgery, 2021, 56(3):198-209.
[9] 代伟林,杜晓辉,屈季宁,等.单侧声带囊肿与声带息肉患者手术前后嗓音声学的对比研究[J].听力学及言语疾病杂志, 2023, 31(1):65-67. DAI W L, DU X H, QU J N, et al.Comparative study of voice acoustics in patients with unilateral vocal cord cyst and vocal cord polyp before and after operation[J].Journal of audiology and speech disorders, 2023, 31(1):65-67.
[10] 李孟,郑宏良,陈世彩,等.一侧膈神经上根联合舌下神经甲舌肌支选择性喉返神经修复术治疗双侧声带麻痹的临床分析[J].中华耳鼻咽喉头颈外科杂志, 2020, 55(11):1016-1021. LI M, ZHENG H L, CHEN S C, et al.Clinical analysis of the treatment of bilateral vocal cord paralysis by selective recurrent laryngeal nerve repair of one superior phrenic nerve combined with sublingual nerve of thyroglossus branch[J].Chinese journal of otolaryngology head and neck surgery, 2020, 55(11):1016-1021.
[11] 王虹,翟红丽,程呈.早期系统发声训练对甲状腺术后声带麻痹患者嗓音质量的影响[J].中国疗养医学, 2022, 31(5):542-544. WANG H, ZHAI H L, CHENG C.Effect of early systemic vocal training on voice quality in patients with vocal cord paralysis after thyroid surgery[J].Chinese journal of convalescent medicine, 2022, 31(5):542-544.
[12] SHAHRIER A Z, CHINCHILLI V M, QURESHI A M, et al.The incidence of recurrent laryngeal nerve injury resulting in vocal cord paralysis following interventional congenital catheterisation procedures[J].Cardiology in the young, 2022, 32(12):1952-1956.
[13] 王燕,屈季宁,周涛,等.自体甲状软骨植入I型甲状软骨成形术治疗单侧声带麻痹[J].听力学及言语疾病杂志, 2022, 30(2):176-179. WANG Y, QU J N, ZHOU T, et al.Treatment of unilateral vocal cord paralysis by type I thyrochondrioplasty with autogenous thyroid cartilage implantation[J].Journal of audiology and speech disorders, 2022, 30(2):176-179.
[14] 雷薇薇,李芳丽,王燕,等.单侧声带麻痹患者嗓音训练效果分析[J].听力学及言语疾病杂志, 2021, 29(6):688-691. LEI W W, LI F L, WANG Y, et al.Effect of voice training on patients with unilateral vocal cord paralysis[J].Journal of audiology and speech disorders, 2021, 29(6):688-691.
[15] INOUE Y, HIRAKAWA K, HAYATA H, etal.Neurolymphomatosis of cranial nerves as the responsible lesions for the vocal cord paralysis and facial nerve palsy in a patient with diffuse large B-cell lymphoma[J].Annals of hematology.2023, 102(2):481-482.
[16] 李丹凤,刘永收,岳波,等.窄带成像技术在显微镜下CO2激光声带切除手术中的应用[J].中国眼耳鼻喉科杂志, 2022, 22(1):59-62. LI D F, LIU Y S, YUE B, et al.Application of narrowband imaging technique in CO2-laser vocal cord resection under microscope[J].Chinese journal of ophthalmology and otolaryngology, 2022, 22(1):59-62.
[17] 徐文.声带注射填充成形手术[J].中华耳鼻咽喉头颈外科杂志, 2020, 55(11):1100-1104. XU W.Vocal cord injection filled plastic surgery[J].Chinese journal of otolaryngology head and neck surgery, 2020, 55(11):1100-1104.
[18] 付鹏,李比.自体脂肪注射隆乳术后超声随访资料的回顾性分析[J].中华整形外科杂志, 2022, 38(6):630-634. FU P, LI B.Retrospective analysis of ultrasound followup data after autologous fat injection for breast augmentation[J].Chinese journal of plastic surgery, 2022, 38(6):630-634.
[19] 胡蓉,徐文,程丽宇,等.声带外侧自体脂肪注射填充术疗效的长期随访研究[J].中华耳鼻咽喉头颈外科杂志, 2023, 58(1):28-36. HU R, XU W, CHENG L Y, et al.Long-term follow-up study of the effect of autologous fat injection on lateral vocal cord filling[J].Chinese journal of otolaryngology head and neck surgery, 2023, 58(1):28-36.
[20] 寿铸,方红雁,何丹.声门旁间隙自体脂肪注射术治疗单侧声带麻痹的疗效分析[J].检验医学与临床, 2022, 19(2):222-224. SHOU Z, FANG H Y, HE D.Effect of paratrophic space autologous fat injection in the treatment of unilateral vocal cord paralysis[J].Laboratory medicine&clinic, 2022, 19(2):222-224.
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