聲門功能不全和吞嚥困難嗆食是一種吞嚥相關複雜的疾病，需要腸胃內科、胸腔內科、耳鼻咽喉頭頸外科、齒顎外科、胸腔外科、復健科等多個專科協調診斷和綜合治療。 藥物和語言吞嚥療法後進行手術干預可以產生一定的效果，但在聲帶注射手術前後控制吞嚥和嗆食至關重要。耳鼻咽喉頭頸外科醫生傳統上使用開放性手術下使用植入物來減少嗆食，但常由於患者的多重病況、導致開放性手術適用性降低，且局限性高。植入式生物醫學材料是新興醫療材料和治療的目標，歷年來使用了碳酸鈣、玻尿酸、自體脂肪和PRP等可注射材料，結果多數優良, 但由於操作者的經驗，手術位置特殊所以很大程度上取決於外科醫生的經驗來做微調。FDA也新批准一項的絲線基底的材料為且明顯針對吞嚥困難和聲音的有改善，這對喉科醫生來說是一個鼓舞人心的消息。
今天的演講將涵蓋注射喉咽成形術的發展、我們機構當前的工作流程以及未來的可能性。
Glottic insufficiency and choking, a swallowing-related disease, are complex conditions requiring coordination between multiple specialties including gastroenterology, chest medicine, otolaryngology-head and neck surgery, dental and maxillofacial surgery, thoracic surgery, rehabilitation, and others for diagnosis and comprehensive treatment. Drug and behavioral therapies followed by surgical intervention can have a stable effect but controlling swallowing and choking before and after glottic closure surgery is critical. Otolaryngology head and neck surgeons have traditionally used implants under open surgery to reduce choking, but this method has limitations due to patient concerns, multi-factorial conditions causing dysphagia and reduced applicability. Implantable biomedical material is a goal of emerging medical materials and treatment, and injectable materials such as calcium carbonate, hyaluronic acid, autologous fat, and PRP are used, but the results vary among patients due to operator experience. Injectable surgical procedures are minimal yet relied largely on the surgeon’s experience. The newly FDA-approved silk-thread-based medical materials offer a sure indication on both dysphagia and voice, which is encouraging note to the laryngologists.
The talk today will cover the evolving of the injectional laryngopharyngoplasty, the current workflow in our institution and the future possibilities. |
