Injection medialization laryngoplasty improves dysphagia in patients with unilateral vocal fold immobility.
Injection medialization laryngoplasty improves dysphagia in patients with unilateral vocal fold immobility.
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DOI：
10.1016/j.wjorl.2018.05.003
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Memon Z
中科院分区：
文献类型：
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作者：
Anis MM;Memon Z
评估单侧声带不动（UVFI）患者在注射内侧化喉成形术前后患者报告的吞咽结局。2015年10月至2017年12月期间由一名临床医生在社区喉科诊所接受注射内移喉成形术的UVFI患者的病例系列和图表审查。在注射前后记录患者报告的吞咽障碍、进食评估工具（EAT-10）、人口统计学、病因学和症状持续时间的有效调查。在IML之前和之后对EAT-10调查进行配对t检验以评估统计学显著性。2015年10月至2017年12月期间，21例患有UVFI和声门闭合不全的患者接受了IML。21例患者中有19例（90%）出现吞咽困难（EAT-10 ≥ 3）。76%的吞咽困难患者报告IML后吞咽功能改善。IML前后UVFI吞咽困难患者的EAT-10评分分别为17.0 ± 14.0和4.2 ± 9.6（p = 0.004）。几乎所有患有UVFI和声门闭合不全的患者都报告了相关的吞咽困难。四分之三的患者在注射内移喉成形术后感觉到吞咽功能的改善。特发性UVFI患者可能会有更持久的改善，而术前严重吞咽困难的患者可能不会受益。进一步的研究是必要的，以完善患者的选择和评估改善吞咽功能的持续时间。
To assess patient reported swallowing outcomes before and after injection medialization laryngoplasty in patients with unilateral vocal fold immobility (UVFI). Case series with chart review of patients with UVFI who underwent injection medialization laryngoplasty at a community laryngology practice by a single clinician between October 2015 and December 2017. Patient-reported validated surveys of swallowing impairment, Eating Assessment Tool (EAT-10), demographics, etiology and duration of symptoms were recorded before and after injection. A paired t test was done on EAT-10 surveys before and after IML to assess for statistical significance. Twenty-one patients with UVFI and glottic insufficiency underwent IML between October 2015 and December 2017. Nineteen of 21 patients (90%) presented with dysphagia (EAT-10 ≥ 3). 76% of patients with dysphagia reported improvement in swallowing function after IML. The EAT-10 scores of UVFI patients with dysphagia before and after IML were 17.0 ± 14.0 and 4.2 ± 9.6, respectively (p = 0.004). Nearly all patients with UVFI and glottic insufficiency report associated dysphagia. Three fourths of these patients perceive improvement in their swallowing function after injection medialization laryngoplasty. Patients with idiopathic UVFI may have a more sustained improvement and those with severe preop dysphagia may not benefit. Further research is necessary to refine patient selection and to assess duration of improved swallowing function.