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以微粉化亞洛登注射喉整型術治療第三聲帶溝

Micronized AlloDerm Injection Laryngoplasty for Type III Vocal Fold Sulcus

Abstracts


背景:微粉化亞洛登注射喉整形術用以治療單側聲帶麻痺所導致之聲門閉合不全,成效顯著,能否運用於治療第3型聲帶溝在國外、國內文獻均尚缺這類的研究報告,於此報告一回溯性系列病例研究。方法:在2003年11月至2004年1月間,共有9名患者納入本研究(8男1女),年齡範圍25~74歲。其中5名在聲門閉合時具有聲門間隙,另4名患者在聲門閉合時不具聲門間隙。在全身麻醉下,接受兩側聲帶甲杓肌之微粉化亞洛登注射,每人注射量均為0.4 mL。結果:術後1個月,全部患者(n=9)的主觀性音聲評估及客觀性音響分析與術前相較均無差異(配對t檢定,α=0.05或0.01)。術後2個月,術前有聲門間隙者(n=5)又獲得與術前相同的聲門間隙。結論:微粉化亞洛登注射喉整形術是手術治療第3型聲帶溝另一種簡單的方法,但在注射後轉換成穩定組織的過程中,也會被周圍組織所吸收。我們首次嘗試使用0.4 mL的注射量,短期追蹤顯示治療效果不佳。

Parallel abstracts


BACKGROUND: The outcome of micronized AlloDerm injection laryngoplasty for unilateral vocal fold palsy is pleasant; however, there is relatively little information currently available on its effectiveness for vocal fold augmentation in patients with Type 3 vocal fold sulcus (VFS). Herein, a retrospective case-series study is reported. METHODS: Between November 2003 and January 2004, nine patients (eight men and one woman), who suffered Type 3 VFS, underwent micronized AlloDerm injection laryngoplasty and were enrolled. Their ages ranged from 25 to 74 years. Five of them had glottic gap and the other four had not. Under endotracheal general anesthesia, the major procedure was injections over the bilateral thyroarytenoid muscles. Every one used a uniform volume of 0.4 mL. RESULTS: One month post-operatively, there was not any improvement of subjective voice evaluations and objective acoustic analysis by paired t-test with an alpha of 0.05 or 0.01. Two months post-operatively, the five patients with pre-operative glottic gaps regained the same glottic gaps as pre-operative. CONCLUSIONS: Micronized AlloDerm injection laryngoplasty is an easy surgical alternative for Type 3 VFS, but the volume of AlloDerm reduced as it was transformed into stable tissue and re-absorbed by surround tissue. We tried the amount of 0.4 mL but the short-term outcome was frustrating.

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