颈部粗短或颈椎病患者的喉动态内镜直视法声带息肉摘除术

目的：探讨喉动态内镜直视下声带息肉摘除术对体胖颈部粗短或颈椎病患者的疗效。方法：对42例体胖颈部粗短或颈椎病患者在喉动态内镜直视下，以弯形声带息肉钳经口咽部行声带息肉摘除术，术中并以喉动态镜观察其声带的对称性、规律性、黏膜波动度及声带闭合度，若发现残留息肉，即时可再次修整摘除。结果：手术均一次成功，无一例发生并发症。术后随访未见复发，音声恢复良好。结论：该术式对体胖颈部粗短或颈椎病患者的声带息肉摘除具有临床应用价值。     

纤维喉镜下手术治疗声带小结和声带息肉疗效观察

目的评价纤维喉镜下手术治疗声带小结和声带息肉的疗效。方法对2862例纤维喉镜下手术治疗声带小结和声带息肉的临床资料进行分析总结。结果全部病例术中无声带损伤，术后无声带粘连。术后3个月复查，治疗声带小结总有效率99．82％，治疗声带息肉总有效率99．77％；术后6个月复查，26例复发。结论纤维喉镜下手术治疗声带小结和声带息肉具有视野清晰、手术准确率高、损伤小、反应轻、患者痛苦少等优点，且简单易行。     

声带息肉的二种手术方法疗效分析

１９９１～１９９６年在纤维喉镜和显微支撑喉镜下共手术治疗声带息肉７５１例,现对这二种手术方法及疗效分析报告如下。１　临床资料及方法１－１　临床资料　声带息肉患者７５１例,病程最短为２个月,最长为１８年,全部患者均以声嘶为主要症状。息肉大小不等,有的小如芝麻,有的大如黄豆。术后均经病理确诊为声带息肉。随访６个月至４年。其中经纤维喉镜手术者２８６例,男１２７例,女１５９例,年龄最大７８岁,最小８岁,平均年龄３５．２岁;广基息肉组（息肉基底宽＞２ｍｍ）３５例,非广基息肉组２５１例。经显微支撑喉镜手术者…     

嗓音声学分析在声带息肉术式的选择及治疗中的应用

摘要：目的比较支撑喉镜下喉显微手术与电子纤维喉镜下YAG激光手术治疗不同类型声带息肉的疗效。方法146例声带息肉患者随机分成两组,其中一组门诊行电子纤维喉镜下YAG激光手术62例,另一组支撑喉镜下显微切除术84例;采用Dr.Speech软件获得两组患者术前1 d、术后1周及术后2周的嗓音基频微扰（jitter）、振幅微扰（shimmer）及嗓音障碍严重指数（dysphonia severity index, DSI）的数值。对嗓音声学参数行统计学分析。结果声带息肉患者术前1 d的基频微扰（jitter）、振幅微扰（shimmer）均高于正常组而DSI偏低,差异均具有统计学意义（P<0.05）;两组患者术后1周及术后2周较术前明显好转;电子喉镜下YAG激光手术与支持喉镜下显微手术处理简单型声带息肉,术后同时段比较差异无明显统计学意义（P>0.05）;支持喉镜下显微手术处理复杂型声带息肉效果优于电子喉镜下YAG激光手术,同时段比较差异均具有统计学意义（P<0.05）;而术后2周与正常对照组比较差异无统计学意义（P>0.05）。结论电子喉镜与支持喉镜处理简单型声带息肉效果相当,处理复杂型声带息肉支持喉镜下显微手术效果更佳。     

支撑喉镜和纤维喉镜下手术治疗声带息肉疗效分析

目的 分析支撑喉镜与纤维喉镜下不同手术方式治疗声带息肉的临床疗效差异性。方法 选择2020年9月～2022年1月在六安市中医院接受治疗的96例声带息肉女性患者作为研究对象，随机分为接受纤维喉镜下手术治疗的对照组及接受支撑喉镜下手术治疗的研究组，比较两组患者的手术时间、住院时长、术后疗效、并发症发生情况等差异。结果 两组患者住院时长无明显差异，对照组手术时间明显短于研究组；研究组患者的术后疗效优于对照组患者；研究组并发症发生率小于对照组，差异均有统计学意义（P<0.05）。结论 在声带息肉的手术治疗过程中，选择支撑喉镜下手术治疗方式取得的疗效更佳，患者并发症发生率更低，适合在临床治疗上广泛应用。     

电子喉镜与支撑喉镜下手术治疗广基型声带息肉疗效分析

近年来声带息肉术式种类繁多，其中电视监控下各种软管喉镜下声带息肉手术，因具有放大、操作方便、图像清晰等优点在国内报道越来越多，而对于广基型声带息肉能否采取此种术式，目前学者意见不一。我们自2004年以来应用电子喉镜切除广基型声带息肉173例，将其与同期传统支撑喉镜下46例广基型声带息肉手术的临床疗效进行对比分析。现报告如下。     

显微支撑喉镜声带息肉切除术后并发舌下神经麻痹1例

声带息肉是耳鼻咽喉科常见病，显微支撑喉镜下声带息肉切除术是耳鼻喉科医生常做的手术之一。该手术常见并发症有：门齿松动脱落、咽黏膜下出血、舌体麻木等。舌肌瘫痪者少见。我们遇到1例全身麻醉下插管经显微支撑喉镜行声带息肉切除术后并发舌下神经麻痹患者，现报告如下。     

电视纤维喉镜下声带息肉及小结摘除术（附68例报告）

目的探讨纤维喉镜下声带息肉及小结摘除的手术适应证及其应用价值。方法采用日本Olympus光导纤维喉镜在局麻下对68例声带息肉及小结患者行手术治疗。结果全部声带息肉及声带小结均一次性手术治愈。结论光导纤维喉镜对声带良性炎性疾患在电视监控下手术具有视野清晰、定位准确、创伤小、无绝对禁忌证等优点，有临床推广价值。     

支撑喉镜下微型电动切削器在声带息肉中的应用

声带息肉是喉科常见病,多发病。手术方法很多,如间接喉镜、直接喉镜、支撑喉镜及纤维喉镜等。各种术式有其利弊,应根据息肉的大小、位置、范围及蒂部情况决定术式[1,2]。对于巨大型及广基型声带息肉或弥漫性肿胀遍及整个声带的息肉样变者,适合用支撑喉镜下手术。我科2000年1月~2004年9月采用支撑喉镜下微型电动切削器切除声带息肉116例,现报道如下。1资料及方法1.1临床资料声带息肉116例,男56例,女60例;年龄18~67岁,平均34.3岁,病程1个月至8年,双侧65例,单侧51例,均以声嘶为主,声带息肉基底较广,息肉直径大于3 mm。1.2仪器及设备国产支撑喉…     

支撑喉镜联合腹腔镜声带息肉及任克水肿的手术初探

目的 探索支撑喉镜联合腹腔镜下手术治疗声带息肉与任克水肿的可行性,评价该术式临床应用的优点.方法 2006年6月～2008年1月,在全麻下经支撑喉镜联合12°直径4 mm腹腔镜监视系统对52例声带息肉患者和12例任克水肿患者实施声带手术,观察手术效果.结果 所有病例均一次性治愈,发声良好,随访10个月以上无复发.结论 通过支撑喉镜联合腹腔镜监视系统直视下行声带病变手术,术野大,利于彻底切除病灶和保护正常声带组织.     

嗓音训练在单侧声带息肉术后嗓音恢复中的应用

目的　探讨单侧大、小声带息肉术后发声功能恢复规律和嗓音训练最佳时机。方法 选取68例武汉市第三医院耳鼻咽喉科行单侧声带息肉手术患者,根据与声带平行的息肉最大直径占同侧声带膜部1/3以下称为小声带息肉,1/3及以上为大声带息肉,分成大声带息肉组30例,小声带息肉组38例,每组随机分成嗓音训练组和禁声组;分别于术前1 d,术后3 d、7 d、2 w行嗓音障碍指数量表、嗓音声学客观参数检测。结果 大、小声带息肉嗓音训练组术后2 w总体评价低于禁声组（P <0.05）,总体评价高于对照组（P >0.05）。大声带息肉嗓音训练组患者术后3 d基频微扰、振幅微扰、嗓音障碍严重指数、最长发声时间与禁声组无统计学差异（P >0.05）,术后7 d、2 w上述指标与禁声组有统计学差异（P <0.05）。小声带息肉组嗓音训练组患者术后3 d、7 d、2 w基频微扰、振幅微扰、嗓音障碍严重指数、最长发声时间与禁声组有统计学差异（P <0.05）,术后2 w大、小声带息肉嗓音训练组与对照组差异均无统计学差异（P >0.05）。结论 单侧小声带息肉患者术后应尽早嗓音训练,单侧大声带息肉患者术后第4天开始嗓音训练更有利于嗓音功能恢复。     

Laryngeal myxoma

Myxoma is a rare benign tumor, and occurs most commonly in the mandible and maxilla in the head and neck region. Myxoma of the larynx is extremely rare and is frequently misdiagnosed as a vocal polyp. We present the first female case of myxoma on a vocal cord and review the literature on this subject. The patient was 74 years old. She had undergone laryngomicrosurgery for a vocal cord polyp 20 years previously, but did not know the histological diagnosis. We performed laryngomicrosurgery for bilateral edematous vocal cords. Microscopic laryngoscopy demonstrated a mass in the submucosal space of the right vocal cord. The pathologic diagnosis of the mass was myxoma. Myxoma is a connective tissue tumor composed of multinucleate stellate cells suspended in an edematous, mucopolysaccharide-rich stroma. Since myxomas may infiltrate surrounding tissue, they have a high incidence of local recurrence. To prevent recurrence, myxoma should be surgically excised with surrounding normal tissue. Although no local recurrence has been detected, as myxoma is characterized by a slow growth rate, long-term follow-up is needed in this case.     

Pathological and clinical assessment of polypoid hypertrophy of the vocal cords

Polypoid hypertrophy of mucosa of the vocal cord is the most common non-neoplastic disease of the larynx. This hypertrophy has a form of simple polyp of vocal cord or polypoid hypertrophy of the whole length of one or both vocal cords. In most cases a course of the disease is typical. In a few cases we can observe changes in polyp epithelium, i.e. hyperplasia or even dysplasia. Clinical and histological analysis of 809 patients treated because of laryngeal polyps (by Kleinsasser microsurgical procedure) within the period of 1981-1995 at ENT Clinic in Gdańsk was made. Sex and age of the patients, macroscopic picture of the disease as well as treatment and results were assessed. Special attention was paid to the problem of polyp epithelium rebuilding. In a few cases, polyp of the vocal cord should be assessed as praecancerous state.     

电子喉镜下巨大声带息肉摘除术

目的：探讨电子喉镜下巨大声带息肉摘除术的可行性及疗效。方法：选择巨大声带息肉患者10例,3例伴有I度呼吸困难,在表面麻醉电子喉镜下行声带息肉摘除术。结果：8例一次性完成手术, 2例分两次完成手术,所有患者无手术并发症,术后3个月的嗓音评价及嗓音测试表明,患者嗓音完全恢复正常。结论：电子喉镜下声带巨大息肉摘除可行,但需充分掌握手术技巧,联合应用表麻药,在做好气管切开的准备情况下进行手术。     

Phonomicrosurgical management of the disease of vocal fold]

OBJECTIVE: To find a way of reserving normal high quality phonatory function after vocal cord surgery. METHODS: Various benign lesions (vocal nodules, polyp of vocal cord, cyst of vocal cord, etc) as well as premalignant lesion and early glottic cancer were treated with minimally excision, lateral microflap, medial microflap, submucosal infusion, mucosal stripping or epithelium stripping of phonomicrosurgical techniques to achieve minimally invasion. RESULTS: The 1,044 (99.8%) patients suffering from vocal nodules, polyp or cyst and 12 Reinke's edema achieved a normal phonation within a week. The recovery of normal phonation in 20 Reinke's edema, 31 vocal cases needed 1-3 months, by mucosal stripping. The restoration of phonation on 5 papilloma, 36 early malignancy were better than trans-cervical operation. After 5 year follow-up, 3 cases of vocal cord premalignant lesions received the re-stripping operation. 32 cases of early glottic cancer remained tumor free, 5 cases relapsed and 2 cases received the re-stripping operation, and 2 cases received laryngectomy operation. CONCLUSION: The phonomicrosurgery may cure vocal disease and reserves good voice function.     

Intubation laryngeal mask: atraumatic diagnostic tool in suspension laryngoscopy

CONCLUSION: The new technique of ILM-guided vocal cord biopsy and APC is safe, cost-effective and non-invasive. It provides excellent airway control, adequate exposure of the vocal cords and effective treatment of laryngeal bleeding. OBJECTIVE: Suspension microlaryngoscopy is a standard diagnostic procedure for vocal cord biopsy. In experienced hands failure of the procedure is extremely rare and may indicate a need for more invasive techniques. The aim of this study was to present a new technique of laryngoscopy/vocal cord biopsy and to review the relevant literature. MATERIAL AND METHODS: After induction of general anesthesia and preoxygenation an intubation laryngeal mask (ILM) was inserted. A flexible bronchoscope was passed through the ILM and an anterior lesion was identified at the vocal cord. Biopsies were taken with forceps inserted through the instrument's working channel. The procedure was performed using video-endoscopic guidance. Bleeding from the wound surface was adequately treated with argon-plasma coagulation (APC). RESULTS: Identification of the vocal cords was readily accomplished using the ILM. Only four literature reports matched our search criteria; all used the standard laryngeal mask or other instruments such as a laser or did not use the procedure for definitive therapy.     

针药加微波治疗声带息肉及小结76例临床研究

目的观察针刺、中药和微波热凝相结合治疗声带息肉及小结的疗效.方法利用纤维喉镜引导软导线针状电极达到病变部位,并刺入病变组织1～2mm,广基底及较大息肉可分多点进行.选择功率40～50W,时间2～3秒,将病变组织凝固、气化.术后给予庆大毒素8万U、地塞米松10mg、α-糜蛋白酶4000U超声雾化吸入3天,每日2次,3天后改"亮嗓汤"雾化吸入,每日2次,每次20分钟.同时针刺开音1号穴及合谷穴,每日1次,每次15分钟.7天一个疗程,连续两个疗程.结果中西医结合组76例中,声带小结总有效率100%.声带息肉总有效率96%.西医组40例中,声带小结总有效率80%,声带息肉总有效率76%,两者进行统计学分析差异有显著性意义(P＜0.01).结论针药加微波热凝治疗声带息肉、小结具有各自疗法的优点,同时克服了不足之处,且疗效好、痛苦小、副作用少、复发率低.     

支撑喉镜下声带息肉手术170例分析

目的探讨声带息肉的手术方式。方法对480例声带息肉病人分别采用支撑喉镜下和间接喉镜下行声带息肉摘除术。结果支撑喉镜下手术治疗治愈率为97.1%;间接喉镜下手术治疗治愈率为98.1%;支撑喉镜下表面麻醉手术组和全身麻醉手术组的治愈率分别为96.2%和97.4%。结论对声带息肉行两种手术方式的临床效果无明显差异(P>0.5),各地医院应根据当地具体情况或医院条件选用不同的手术方式。