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目的通过观察经喉外进路及经支撑喉镜下行CO2激光手术切除杓状软骨治疗双侧声带神经麻痹的疗效,对比两种手术方法的优缺点,择优选取合适的术式。方法对双侧喉返神经致喉狭窄的13例术后患者进行随访,其中7例行喉外进路杓状软骨切除术声带外展固定,6例行经支撑喉镜下行CO2激光手术切除杓状软骨,13例术前均已行气管切开,术后随访6个月至2年。结果采用喉外进路杓状软骨切除术声带外展固定7例,术后1次拔管3例,2次拔管2例;采用经支撑喉镜下行CO2激光手术切除杓状软骨6例,术后1次拔管4例,2次拔管1例。结论两种手术方法各有优缺点。
Objective To observe the curative effect of bilateral vocal cord nerve paralysis by removing the arytenoid cartilage by CO2 laryngectomy and CO2 laryngotracheal surgery via the larynx laryngoscope and to compare the advantages and disadvantages of the two surgical methods. Methods Thirteen patients with postoperative laryngeal stenosis of bilateral recurrent laryngeal nerve were followed up, of whom 7 cases underwent laryngeal arytenotomy for vocal cord abduction and 6 cases underwent laryngectomy via CO2 laryngoscope. 13 cases were treated by tracheotomy and were followed up for 6 months to 2 years. Results Thoracotomy was performed in 7 cases of vocal fold ectasia, 3 cases were extubated after operation and 2 cases were extubated in 2 cases. 6 cases of arytenoid cartilage were removed by CO2 laryngoscope through the support laryngoscope, After extubation in 4 cases, 2 extubation in 1 case. Conclusion Both methods have their advantages and disadvantages.