单侧声带麻痹早期与晚期注射喉成形术的比较
Early Versus Late Injection Laryngoplasty for Unilateral Vocal Fold Paralysis.
文献信息
| PMID | 42860243 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ahmed S Abdelmeguid |
| 作者单位 | Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia Governorate, Egypt. |
| 期刊 | Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery |
| SCI 分区 | Q2 |
| IF | 2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 单侧声带麻痹（UVFP）是一种以一侧声带功能性运动丧失为特征的疾病，导致声门闭合不全，从而损害发声、吞咽和咳嗽等基本功能。注射内移喉成形术可暂时恢复声门闭合，改善嗓音质量，并可能降低误吸风险。
患者与方法： 一项前瞻性队列研究于2024年9月至2026年1月进行。将UVFP患者分为早期组（从麻痹发病起<6个月）和晚期组（≥6个月）。所有患者均接受使用透明质酸（Perfectha Derm，20 mg/mL）的注射内移术。该操作在局部麻醉或全身麻醉下进行。在注射前以及注射后1个月和6个月进行嗓音评估，包括最长发声时间（MPT）、GRBAS、使用PRAAT进行的声学分析（基频微扰、振幅微扰、谐噪比）以及患者报告的阿拉伯语嗓音障碍指数（VHI）。
结果： 共纳入48例UVFP患者，分为早期组（<6个月）和晚期组（≥6个月）。早期注射组在1周和6个月时显示出显著更高的MPT。与接受较晚注射的患者相比，早期注射组需要I型甲状软骨成形术的患者更少（p = 0.001）。早期组的长期声学指标也更优，表明嗓音质量更好。
结论： 与晚期注射相比，早期注射喉成形术与更优的长期嗓音结局以及显著降低的永久性内移手术需求相关。这些发现强调了早期干预在UVFP管理中的临床重要性。
英文摘要
OBJECTIVES: Unilateral vocal fold paralysis (UVFP) is a condition characterized by the loss of functional movement of one vocal fold resulting in incomplete glottic closure, which compromises essential functions such as phonation, swallowing and coughing. Injection medialization laryngoplasty can temporarily restore glottic closure, improving voice quality and potentially reducing the risk of aspiration.
PATIENTS AND METHODS: A prospective cohort study was conducted from September 2024 to January 2026. Patients with UVFP were divided into early (< 6 months from the onset of paralysis) and late (≥ 6 months). All patients received injection medialization using hyaluronic acid (Perfectha Derm, 20 mg/mL). This was done either under local anaesthesia or under general anaesthesia. Voice assessment was done before injection and at 1 and 6 months post-injection, including maximum phonation time (MPT), GRBAS, acoustic analysis (jitter, shimmer, HNR) using PRAAT and patient-reported Arabic Voice Handicap Index (VHI).
RESULTS: Forty-eight patients with UVFP were enrolled and divided into early (< 6 months) and late (≥ 6 months) groups. The early injection group showed significantly higher MPT at 1 week and 6 months. Fewer patients required Type I thyroplasty in the early injection group compared to patients who underwent later injection (p = 0.001). Long-term acoustic measures were also superior in the early group, indicating better voice quality.
CONCLUSION: Early injection laryngoplasty was associated with superior long-term voice outcomes and a significantly reduced need for permanent medialization surgery compared with late injection. These findings highlight the clinical importance of early intervention in the management of UVFP.