陳旧性片側声帯麻痺に対する反回神経再建術

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タイトル別名
  • Reinnervation of Recurrent Laryngeal Nerve for Treatment of Unilateral Vocal Fold Paralysis
  • チンキュウ セイ カタガワ セイタイ マヒ ニ タイスル ハン カイ シンケイ サイケンジュツ : チリョウ コウカ ト イギ
  • —治療効果と意義—

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Reinnervation of recurrent laryngeal nerve was performed on 17 cases with unilateral vocal fold paralysis. The period of paralysis ranged from 3 months to 8 years. Fixation of the vocal fold within an intermediate section and severe atrophy were observed in all 17 cases preoperatively. The preoperative maximum phonation time (MPT) was 1 to 4 seconds (median : 2.1 seconds). Sixteen cases underwent anastomosis from the ansa cervicalis to the recurrent laryngeal nerve, and only 1 case underwent reconstruction by interposition. Disposition of the paralyzed vocal fold in the paramedian portion was observed in 15 cases, and improvement of vocal fold atrophy was observed in the same 15 cases. There was marked improvement of MPT in 15 cases postoperatively, to a span of 9 to 24 seconds (median : 14.3 seconds). We considered indications of reinnervation to be preservation of the distal stump for the recurrent laryngeal nerve and a good prognosis to be at least 12 months. Reinnervation of the recurrent laryngeal nerve is useful for treating unilateral vocal fold paralysis.

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