內視鏡杓狀軟骨雷射切除術治療兩側聲帶麻痺

以內視鏡杓狀軟骨雷射切除術來治療兩側聲帶麻痺的病人，其觀念是建立在擴大後三分之一聲門以改善呼吸，同時不傷害前三分之二聲門以保存聲音。然而臨床上卻會遇到術後病人呼吸無法得到滿意的改善，或聲音變差的情況。有提出以雷射來翻開黏膜瓣與準確的分離杓狀軟骨，並以完整摘除取代汽化的步驟，來確保呼吸道的通暢和避免併發症的發生。本科自1993年3月至1994年4月共有7名兩側聲帶麻痺患者接受此種變通的杓狀軟骨切除術，在半年到1年半的追蹤裡，發現所有病人，除了在呼吸上有明顯改善外，也都能維持原有的聲音。臨床上在面對兩側聲帶麻痺的病人，這種變通的杓狀軟骨切除術提供了另一種的嘗試。

關鍵字

聲帶麻痺；內視鏡杓狀軟骨雷射切除術

並列摘要

The concept of treating patients with bilateral vocal fold paralysis by endoscopic laser arytenoidectomy is aimed at enlarging the posterior one-third of the glottis to improve breathing and keeping undamaged the anterior two-thirds of the glottis to facilitate phonation. But clinically, this operation sometimes does not result in satisfactory improvement of breathing. Furthermore, it may even hurt the voice. This paper presents an alternative surgical procedure of the endoscopic laser arytenoidectomy which ensures a smooth airway and prevents possible complications by using laser to develop the mucosal flap and precisely separate the body of arytenoids cartilage, as well as by complete removal of cartilage instead of vaporization. Seven patients with bilateral vocal fold paralysis were treated by the alternative endoscopic laser arytenoidectomy from March 1993 to April 1994. After the follow-up periods from six to eighteen months, all patients not only had obvious better breathing, but also maintained their preoperative voice. Currently, this alternative surgical procedure is very likely to be an effective and practical treatment choice for patients with bilateral vocal fold paralysis.

並列關鍵字

Vocal fold paralysis ； endoscopic laser arytenoidectomy

國際替代計量

內視鏡杓狀軟骨雷射切除術治療兩側聲帶麻痺

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