Article record

内收型痉挛性发声障碍中II型甲状软骨成形术的手术适应证：一项范围综述

Surgical Indications for Type II Thyroplasty in Adductor Spasmodic Dysphonia: A Scoping Review.

综述 Meta咽喉科IF 2.3Q2

文献信息

PMID	42829938
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Marice Sangalang 查看其他 4 位作者 Tetsuji Sanuki；Ahmed Geneid；Yakubu Karagama；Nobuhiko Oridate
作者单位	Department of Otolaryngology-Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 查看其他 5 条单位信息 Department of Otolaryngology-Head and Neck Surgery, Amang Rodriguez Memorial Medical Center, Marikina, Philippines.；Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.；Department of Otorhinolaryngology, Guy's & St Thomas' NHS Foundation Trust, London, UK.；King's College University, London, UK.；Department of Otolaryngology-Head & Neck Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
期刊	The Laryngoscope
SCI 分区	Q2
IF	2.3
研究类型	综述 Meta · 临床
所属专科	咽喉科

中文摘要

目的： 本范围综述梳理了关于使用钛桥的II型甲状软骨成形术治疗内收型痉挛性发声障碍的手术入选标准、疗效、持久性和安全性的证据，以识别研究间的空白和不一致之处，并提出初步的国际手术适应证标准和核心结局指标集以供未来验证。
数据来源： 检索了PubMed/MEDLINE和Cochrane Library，从建库至2026年1月5日。
综述方法： 两名独立评审员根据入选标准评估全文文章。使用ROBINS-I V2评估偏倚风险。
结果： 共识别出32项研究，其中15项符合纳入标准。手术适应证异质性较大，包括对肉毒毒素注射反应不充分的患者，以及反应良好但寻求永久替代反复注射的患者。平均嗓音障碍指数-10评分从术前的26.3-30.4改善至术后的4.1-14.0，改善持续长达8.4年。感知、声学和空气动力学参数在术后显著改善。翻修率为2%至7%，并发症轻微且短暂。钛桥断裂与症状复发无一致关联。
结论： 使用钛桥的II型甲状软骨成形术在内收型痉挛性发声障碍中提供了持久且具有临床意义的嗓音结局，翻修率低且安全性可接受。证据支持基于标准化诊断、症状慢性化、既往保守治疗以及排除其他嗓音障碍的初步手术资格框架。有必要制定和验证国际手术适应证标准及核心结局指标集，以支持可比性和全球实施。
证据等级： 不适用。

英文摘要

OBJECTIVE: This scoping review mapped evidence on surgical eligibility criteria, efficacy, durability, and safety of Type II thyroplasty with titanium bridges for adductor spasmodic dysphonia to identify gaps and inconsistencies among studies and propose preliminary international surgical indication criteria and a core outcome set for future validation.
DATA SOURCES: PubMed/MEDLINE and Cochrane Library were searched from inception to January 5, 2026.
REVIEW METHODS: Two independent reviewers evaluated full-text articles based on eligibility criteria. Risk of bias was assessed using ROBINS-I V2.
RESULTS: Overall, 32 studies were identified and 15 met the inclusion criteria. Surgical indications were heterogeneous, including patients with inadequate response to botulinum toxin injection and those who responded well but sought a permanent alternative to repeated injections. Mean Voice Handicap Index-10 scores improved from 26.3-30.4 preoperatively to 4.1-14.0 postoperatively, with sustained improvement up to 8.4 years. Perceptual, acoustic, and aerodynamic parameters significantly improved postoperatively. Revision rates ranged from 2% to 7%, and complications were minor and transient. Titanium bridge fractures were not consistently associated with symptom recurrence.
CONCLUSION: Type II thyroplasty with titanium bridges provides durable and clinically meaningful voice outcomes in adductor spasmodic dysphonia, with low revision rates and acceptable safety. The evidence supports a preliminary framework for surgical eligibility based on standardized diagnosis, symptom chronicity, prior conservative therapy, and exclusion of other voice disorders. Development and validation of international surgical indication criteria and a core outcome set are necessary to support comparability and global implementation.
LEVEL OF EVIDENCE: N/A.