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手术治疗各种原因引起的双侧外展肌麻痹所致的通气和发音障碍通常有喉外进路声带外展术和内窥镜下杓状软骨切除术。Thornell氏内窥镜杓状软骨切除术是最直接和最简单的方法,该法不作喉外切口并对通气道的大小当时就可作出估价。不过这种手术使用普通的手术钳、刀等器械,容易出血,手术难度大,易形成瘢痕。1972年S trong等采用二氧化碳激光手术使Thornell氏术的效果得到了提高。作者报道7年来共为20例双侧外展肌麻痹的病人作了内窥镜下激光杓状软骨切除术。术中应用40W二氧化碳激光器和Z eiss手术显微镜。19例采用气管内插管全麻,1例静脉给安定,配合达克罗宁表麻及1%利多卡因喉上神经阻滞。通过Jako喉镜将气管插管前移而暴露杓状软骨。激光功率一般用18～20W,持续0.2～0.5秒。先
Surgical treatment of various causes of bilateral abductor abscess caused by paralysis of the ventilation and speech disorders are usually extra-thoracoscopic vocal cord outreach and endoscopic arytenoid cartilage resection. Thornell’s endoscopic arytenoidectomy is the most straightforward and easiest way to estimate the size of an airway without making a laryngectomy. However, this operation using ordinary surgical forceps, knives and other equipment, easy bleeding, difficult operation, easy to form scars. In 1972 S trong and other use of carbon dioxide laser surgery so that the effect of Thornell’s surgery has been improved. The authors report that endoscopic laser arytenotomy was performed in 20 patients who had bilateral abductor abduction in seven years. Intraoperative use of 40W carbon dioxide laser and Z eiss surgical microscope. Twenty-nine patients received endotracheal intubation, one patient received intravenous diazepam and dacronine ephedrine and 1% lidocaine laryngeal nerve block. The tracheal intubation was advanced by the Jako laryngoscope to expose the arytenoid cartilage. Laser power is generally 18 ~ 20W, for 0.2 ~ 0.5 seconds. first