甲状腺手术后口服皮质类固醇治疗声麻:一项随机临床试验
Eleonor Carvajal-Alegria1, Nathalie Girault1, Gianluca Donatini2
1Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Poitiers, Poitiers, France.
JAMA otolaryngology-- head & neck surgery
|August 7, 2025
概括
口服皮质类固醇在手术后单侧声麻的患者中没有改善声带再动员或语音质量. 语音治疗仍然是管理这种情况的关键组成部分.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 内分泌学 在内分泌学.
- 外科手术的结果
背景情况:
- 甲状腺切除术后单边声麻 (VFP) 缺乏共识管理策略.
- 假设炎症会导致VFP,当没有复发的喉神经截断时.
- 皮质类固醇正在研究其潜在的治疗效果.
研究的目的:
- 评估7天口服皮质类固醇治疗方案的疗效.
- 评估甲状腺切除术或副甲状腺手术后单边VFP患者的声带再动员和语音质量.
主要方法:
- 一个前性,随机,双盲,安慰剂对照试验 (NCT03553342).
- 包括接受甲状腺切除术或副甲状腺手术的患者.
- 在基线,手术后的一天,七天,一个月和三个月评估声带的移动性 (纳索纤维镜) 和语音质量 (GRBAS尺度).
- 单侧VFP患者接受了口服皮质类固醇或安慰剂7天.
主要成果:
- 468名患者中有26名 (5.6%) 患有单边VFP.
- 在皮质类固醇 (42.8%) 和安慰剂 (41.6%) 组之间,在第7天声带再动员没有显著差异.
- 在任何时间点,群体之间语音质量 (GRBAS尺度) 没有显著差异.
结论:
- 口服皮质类固醇似乎没有增强声带再动员或改善后术单侧VFP的语音质量.
- 在甲状腺切除术或副甲状腺手术后,语音治疗仍然是管理VFP的重要干预措施.
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