Collagen Injection as a Supplement to Arytenoid Adduction for Vocal Fold Paralysis
Collagen Injection as a Supplement to Arytenoid Adduction for Vocal Fold Paralysis
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胶原注射作为杓状腱内收的补充治疗声带麻痹
DOI：
10.1177/000348940811700605
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
R. Chan
中科院分区：
文献类型：
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作者：
M. Kimura;T. Nito;H. Imagawa;N. Tayama;R. Chan
目的：声带麻痹伴发的发音困难即使在成功的内移术（包括杓状软骨内收术）后仍可能持续。据推测，喉胶原注射可以改善特定患者杓状软骨内收术后的发音。我们的目的是评估胶原蛋白注射如何导致发声功能和声音质量的可测量的改善。研究方法：40例单侧声带麻痹患者接受了杓状软骨内收术，通过间接喉镜和弯曲注射装置经口注射非交联牛真皮胶原蛋白。对照组40例患者行杓状软骨内收术，但不注射胶原蛋白。用GRBAS量表对患者的嗓音质量进行感知评估，并通过声学和空气动力学测量（最大发声时间和跨声门DC流）评估发声功能。还通过视频频闪镜检查评估了相对声门面积。结果如下：对于那些单独进行杓状软骨内收不能获得满意声门功能的患者，胶原蛋白注射可以显著改善其发声功能和声音质量。声门面积测量显示，声门功能不全显着减少后杓状软骨内收，以及胶原注射后。结论：结果提示，胶原注射是改善杓状软骨内收术后嗓音的有效辅助治疗方法。它的优点是微创门诊手术。应探讨该手术的长期疗效。
Objectives: Dysphonia associated with vocal fold paralysis can persist even after successful medialization procedures, including arytenoid adduction. It is hypothesized that laryngeal collagen injection could improve phonation following arytenoid adduction in selected patients. Our objective was to evaluate how collagen injection could result in measurable improvements in vocal function and voice quality. Methods: Forty patients with unilateral vocal fold paralysis who had undergone arytenoid adduction underwent transoral injection of non—cross-linked bovine dermal collagen by means of indirect laryngoscopy and a curved injection device. A control group of 40 patients underwent arytenoid adduction but not collagen injection. The patients' voice quality was assessed perceptually with the GRBAS scale, and vocal function was assessed by acoustic and aerodynamic measures (maximum phonation time and transglottal DC flow). The relative glottal area was also assessed by videostroboscopy. Results: Significant improvements in vocal function and voice quality were observed with collagen injection for those patients who did not achieve satisfactory glottal competence with arytenoid adduction alone. Glottal area measurements revealed that glottic insufficiency was significantly reduced after arytenoid adduction as well as after collagen injection. Conclusions: The findings suggest that collagen injection could be an effective supplementary treatment for improving voice following arytenoid adduction. It has the advantage of being a minimally invasive outpatient office procedure. The long-term efficacy of the procedure should be explored.