氣管切開後聲帶位置及運動之探討

Investigation of Vocal Fold Position and Movement after Tracheotomy

李憲彥(Shiann-Yann Lee) ； 葉德輝(Te-Huei Yeh) ； 陳建銓(Jiann-Chyuan Chen) ； 林大傑(Da-Jie Lin) ； 林萬哲(Oan-Che Linne)

《中華民國耳鼻喉科醫學會雜誌》 30卷5期 (1995/10) Pp. 463-468

https://doi.org/10.6286/1995.30.5.463

摘要

Changes in position and movement of the vocal folds after tracheotomy have been widely studied in animals with controversial results, but the same study has been little done in humans. This study tries to elucidate the early changes of vocal fold function after tracheotomy in humans. Seventeen patients receiving tracheotomy in the National Taiwan University Hospital were selected. None of them had diseases directly related to the larynx. The vocal fold position and movement were recorded and analyzed postoperatively using a fiberoptic rhinolaryngoscope and videophotography. Twenty healthy adults were selected as a control group. The results showed that the maximum respiratory abduction of the vocal folds was reduced in the tracheotomy group. The vocal folds remained in the intermediate position after tracheotomy and had smaller range of motion. The cyclic respiratory movement of the vocal folds was still retained. This unique finding may provide insight into the pathophysiology of versatile clinical problems related to tracheotomy. For example, the pathogenesis of laryngotracheal stenosis following tracheotomy in laryngeal trauma and the problems of difficult decannulation in tracheotomized patients. A long-term investigation of chronic tracheotomized patients is mandatory for further elucidation of this clinical entity.

關鍵字

氣管切開術，聲帶位置

並列摘要

Changes in position and movement of the vocal folds after tracheotomy have been widely studied in animals with controversial results, but the same study has been little done in humans. This study tries to elucidate the early changes of vocal fold function after tracheotomy in humans. Seventeen patients receiving tracheotomy in the National Taiwan University Hospital were selected. None of them had diseases directly related to the larynx. The vocal fold position and movement were recorded and analyzed postoperatively using a fiberoptic rhinolaryngoscope and videophotography. Twenty healthy adults were selected as a control group. The results showed that the maximum respiratory abduction of the vocal folds was reduced in the tracheotomy group. The vocal folds remained in the intermediate position after tracheotomy and had smaller range of motion. The cyclic respiratory movement of the vocal folds was still retained. This unique finding may provide insight into the pathophysiology of versatile clinical problems related to tracheotomy. For example, the pathogenesis of laryngotracheal stenosis following tracheotomy in laryngeal trauma and the problems of difficult decannulation in tracheotomized patients. A long-term investigation of chronic tracheotomized patients is mandatory for further elucidation of this clinical entity.

並列關鍵字

tracheotomy, vocal fold position