喉頭枠組手術 再手術例の検討

Abstract

Between 1988 and 1995, 54 patients underwent laryngeal framework surgery, to treat glottal insufficiency due to unilateral vocal cord paralysis at Osaka Red Cross Hospital. Thyroplasty type I was performed initially in 33 patients, arytenoid adduction was performed in 18 patients, and combined thyroplasty type I and arytenoid adduction was performed in 3 patients. To date, 5 patients who had poor results from their initial surgery have undergone revision laryngeal framework surgery. Three patients who initially underwent arytenoid adduction underwent revision thyroplasty type I as a secondary procedure. Patients with vocal cord atrophy initially had to undergo combined thyroplasty type I and arytenoid adduction. Two patients who initially underwent thyroplasty type I underwent revision thyroplasty type I, with placement of a larger silicon block implant. At surgery, the tissue adjacent to the previously implanted silicon block exhibited the formation of a thin fibrous capsule. The silicon block implant was easily removed and replaced with a different, largersized, silicon block implant. The results of the revision surgery were satisfactory in all five patients.