显微手术联合A型肉毒素注射治疗声带突肉芽肿

马丽晶; 肖洋; 叶京英; 杨庆文; 王军

doi:10.13201/j.issn.1001-1781.2015.02.012

显微手术联合A型肉毒素注射治疗声带突肉芽肿

- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科耳鼻咽喉头颈外科教育部重点实验室(北京, 100730)

详细信息

通讯作者: 王军,E-mail:wmzi2002@163.com

中图分类号: R767.4

收稿日期: 2014-08-20

Surgical excision and botulinum toxin A injection for vocal process granuloma

- 1 Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, 100730, China

More Information

Corresponding author: WANG Jun, E-mail: wmzi2002@163.com

Received Date: 20 August 2014

摘要

摘要: 目的:研究喉显微外科手术联合A型肉毒素局部注射对声带突肉芽肿的治疗效果。方法:28例声带突肉芽肿患者,采用全身静脉麻醉,经口插入气管导管,支撑喉镜暴露病变,在显微镜下应用喉显微剪刀及CO₂激光切除病变,8-0可吸收缝线对位缝合创缘黏膜,封闭创面,在患侧甲杓肌分四点注射A型肉毒素8~15 u,术后给予布地奈德气雾剂雾化治疗1周;伴胃食管返流者给予抑酸治疗。结果:所有患者注射侧声带术后2~3 d出现运动障碍。术后1个月,28例患者手术创面愈合良好,注射侧声带活动受限;术后3个月,双侧声带活动正常,声带突黏膜光滑。随访1年以上,1例患者于术后2个月时发现肉芽肿复发,治愈率为96.4%。结论:以喉显微手术联合A型肉毒素局部注射治疗声带突肉芽肿,能够缩短治疗时间,提高治愈率。
- 声带突肉芽肿 /
- 外科手术 /
- A型肉毒素
Abstract: Objective: To study the efficacy of treatment with microsurgery in combination with local injection of type A botulinum toxin for vocal process granuloma.Method: 28 patients with vocal process granuloma received endotracheal intubation under general anesthesia. The lesion was removed with micro-scissor and CO₂ laster under a self-retaining laryngoscope and microscope. The incision and mucous membrane surrounding the wound was closed with 8-0 absorbable suture.4-point injection of botulinum toxin type A 8-15 u was then performed along the thyroarytenoid muscle and arytenoid muscle of the same side. Postoperative medication was administered based on disease causes.Result: All patients experienced vocal cord dyskinesia of the injected side 2-3 days after surgery. At 1 month after the surgery, wound healing was good in all the 28 patients, and the vocal cord movement was limited at the injected side. At 3 months, movement of the bilateral vocal cords was normal, and the vocal cord process mucosa was smooth. Patients were followed up for more than a year, and only one patient had recurrence in 2 months after surgery. The cure rate was 96.4%. Conclusion: Combination of laryngeal microsurgery and type A botulinum toxin local injection can shorten the treatment course of vocal process granuloma.
- vocal process granuloma /
- surgery /
- type A botulinum toxin

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