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本文报道采用CO_2激光手术治疗6例双侧声带麻痹患者,全部获得成功。患者均为女性,年龄16～54岁。5例为甲状腺手术损伤双侧喉返神经,1例为刎颈所致。治疗前都已作气管切开,历时3月至2年。激光手术是切除一侧杓状软骨声突和50%声皱襞和声韧带。术前先行显微喉镜检查。CO_2激光功率为20W,持续0.5秒。微操纵器精确地将光束引至预定部位,注意勿伤及近前联合的同侧声带2 mm处,以免术后喉蹼形成。施行此术可使声突基部平面的声门间隙宽达8 mm左右。治疗后全部除管,呼吸通畅,发声良好。迄今无1例失败。双侧声带麻痹的治疗目前仍是一难题,文献中偶有采用激光切除杓状软骨治疗的报道。近10年来开展的舌下神经襻肌蒂移植于麻痹的环杓后
This paper reports the use of CO_2 laser surgery in 6 patients with bilateral vocal cord paralysis, all were successful. Patients were female, aged 16 to 54 years. Five cases had bilateral recurrent laryngeal nerve injury in thyroid surgery, and one case was caused by cusp neck. Have been treated before tracheotomy, which lasted from March to 2 years. Laser surgery is the removal of arytenoid stenosis and 50% of acoustic folds and vocal cord. Preoperative micro-laryngoscopy. CO 2 laser power is 20W for 0.5 seconds. The micromanipulator accurately directs the beam to a predetermined location, taking care not to injure the ipsilateral vocal cord at a distance of 2 mm, to prevent the formation of postoperative throat webs. The implementation of this technique can make the sound bursts of the glottis gap width of the plane of about 8 mm. After treatment in addition to all the tubes, breathing patency, sound good. So far no one failed. The treatment of bilateral vocal cord paralysis is still a problem, the literature occasionally used the report of laser resection of arytenoid cartilage. Sublingual nerve 襻 muscle pedicle carried out in the past 10 years after transplantation in the paralysis of the crab