儿童双侧声带麻痹诊治的现状与进展

Current status and research progress in diagnosis and treatment of bilateral vocal cord paralysis in children

摘要:

双侧声带麻痹(BVCP)是指双侧支配咽喉部肌肉运动的神经传导通路受损引起的双侧声带运动障碍，占儿童先天性喉部异常疾病的第二位。主要症状为上气道梗阻、喘鸣、声音嘶哑等。其病因包括神经性、医源性、特发性及其他病因。临床可行病因评估、声带运动振动评估、影像学检查、喉肌电图及喉超声等检查评估。缓解呼吸道阻塞为治疗的主要目的，恢复喉的生理功能为治疗的最终目标。治疗方法有无创正压通气、气管切开术、环状软骨裂开术、杓状软骨切除术、声带后端切断术、声带外移固定术、选择性喉神经修复术、肉毒杆菌毒素注射喉内肌及其他新兴治疗方法。

关键词:声带麻痹;儿童;诊断;治疗

Abstract:

Bilateral vocal cord paralysis refers to bilateral vocal cord dyskinesia caused by damage to the nerve conduction pathway that controls muscle movement in the throat. It is the second most common congenital laryngeal disease in children. The main symptoms are upper airway obstruction, stridor and hoarseness. The etiology of bilateral vocal cord paralysis includes neurologic, iatrogenic, idiopathic and other etiology. It could be performed for clinical evaluation of etiology, vocal cord motion vibration, imaging, laryngeal electromyography and laryngeal ultrasound. The main goal of treatment is to relieve respiratory obstruction, and to restore the physiological function of the larynx. Treatment options include invasive positive pressure ventilation, tracheostomy, annular cartilage dehiscence, diploidous cartilage resection, posterior vocal cord tomy, vocal cord exotaxis, selective laryngeal nerve repair, botulinum toxin injection into the internal laryngeal muscle, and other emerging treatments.

Key words:Vocal cord paralysis;Children;Diagnosis;Treatment