披裂軟骨内転術の成績

Abstract

Arytenoid adduction surgery was performed on 27 patients with unilateral recurrent laryngeal or vagus nerve palsy, and the results were evaluated. The AC/DC ratio and mean airflow rate were significantly improved (p<0.01) and the improvements persisted for a long follow-up period postoperatively in the majority of patients. The results of phonatory function showed no difference between cases with or without type I thyroplasty or intracordal injection, although there was considerable variability in the AC/DC ratio after surgery. Differences in the level and thickness ratio between the vocal folds were significantly corrected on laryngeal tomography (p<0.01). In patients with combined vagal and hypoglossal nerve palsy, swallowing disturbance is a serious problem. Arytenoid adduction surgery decreased misswallowing and improved the ability to expel an aspirated bolus or sputum in the trachea. Oral feeding became possible in four patients out of seven. These improvements were primarily attributed to increased infraglottic pressure.