Progress in laryngeal framework surgery
Progress in laryngeal framework surgery
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DOI：
10.1080/000164800750000748
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发表时间：
2000-01-01
影响因子：
1.4
通讯作者：
Isshiki, N
中科院分区：
文献类型：
--
作者：
Isshiki, N
本文就喉支架手术自25年前首次报道以来的进展作一综述。这种类型的手术的成功需要发声生理学的基本知识，以便做出关于手术程序的决定，以及手术技巧，以便成功地完成预期的程序。声音嘶哑的主要原因是声门闭合不完全，但声音嘶哑的第二个最重要的原因是声带僵硬增加，不能通过单纯的声带内侧化来纠正。喉支架手术与传统手术的概念不同，传统手术的目的是切除病变。这里讨论的关于I型甲状腺成形术的争议点包括：（i）是否应该去除软骨窗;（ii）固定软骨窗的材料;（iii）I型甲状腺成形术与杓状软骨内收术的比较。一种新的手术治疗痉挛性发声障碍和它的结果在三个病人的简要介绍。提高音调的手术需要进一步改进。今后，喉支架手术将在治疗发音障碍方面有更广泛的应用，如专业歌手因萎缩或衰老而导致的声音虚弱，女性的音高问题以及性别认同障碍和痉挛性发音障碍。
This paper reviews progress in laryngeal framework surgery since it was first reported about 25 years ago. The success of this type of surgery requires both a basic knowledge of the physiology of phonation, in order to make decisions about the surgical procedure, and surgical skill, in order to accomplish the intended procedure successfully. The main reason for hoarseness is imperfect closure of the glottis, but the second most important reason for hoarseness, increased stiffness of the vocal fold, cannot be corrected by mere medialization of the vocal fold. Laryngeal framework surgery is different in concept from conventional surgery, which is intended to remove the lesion. Controversial points discussed here regarding type I thyroplasty include: (i) whether the cartilage window should be removed; (ii) materials for fixation of the window; and (iii) comparison of type I thyroplasty with arytenoid adduction. A new surgical treatment fur spasmodic dysphonia and its results in three patients are described briefly. Surgery for raising the vocal pitch requires further improvement. In the future, laryngeal framework surgery will have wider application in treatment of dysphonias, such as asthenic voice due to atrophy in professional singers or aging, pitch problems in females and gender identity disorder and spasmodic dysphonia.