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1、喉结■声门偏斜的临床观察听力学及言语疾病杂志1999年第3期第7卷论著作者：周定蓉关立谦陈继川单位：第三军医大学大坪医院耳鼻咽喉科(重庆400042)关键词：声门偏斜；喉扭转；甲状软骨【摘要】目的探讨喉结■声门偏斜的临床特征及其机理。方法分析45例喉结■声门偏斜病例的临床资料。结果男性占97.8%,喉结偏右为82.2%；8例声门不偏，其余前连合偏向与喉结一致；喉结偏向对侧、同侧及对照组的甲状软忖翼板横径依次为4.7±0.5cm、3.3±0.5cm及4.0±0.4cm,三组间差异极显著；翼板宽大侧有19例伴上角丿把
2、厚。结论喉上神经■环甲肌■环甲关节■咽下缩肌(环•咽系统)为维持止常喉位主耍因素，一侧环■咽系统功能亢进导致喉结•声门偏斜，偏向对侧的甲状软骨翼板增人及上角肥厚。上角肥厚所致喉上神经痛可经理疗及封闭控制。DeviationofProminentiaLaryngeaandGlottis:AClinicalObservationZhouDingrong,GuanLiqian,ChenJichuan.(DepartmentofOtolaryngology,DopingHospital,ThirdMilitaryColl
3、ege,Chongqing,420042)【Abstract]ObjectiveToexplorethecharacteristicsandthemechanismaboutdeviationoftheprominentialaryngea(PL)andtheglottis・MethodsTheclinicaldataof45patientswithdeviationofthePLandglottiswereanalysed・ResultsThemaleaccountedfor97.2%andthePLdevia
4、tedtowardstherightwasfoundin45cases(82.2%)・Alltheglotticanteriorcommissure,except8caseswithoutthedeviatedglottis,wasipsilateraldeflectionwiththePL.Thetransversediametersofthelaminaofthyroidcartilage(LTC),inoppositiontothePLdeviated,ipsilateralwiththePLdeviate
5、dandthecontralgroup,were4.7+0.5cm,3・3±0・5cmand4.0±0.4cm,respectively,Thedifferenceinthreegroupswasobvious・Thehypertrophicsuperiorhornofthethyroidcartilagein19caseswasallaccompaniedwiththeincreasedtransversediameteroftheETC・ConclusionThesuperiorlaryngealnerve,
6、cricothyreoideus,cricothyroidjointandinferiorconstrictorpharyngis(cricoid-pharyngealsystem)areamainfactorforkeepingnormallarynxlocation.Hyperfunctionofunilateralcricoid-pharyngealsystemledtodeviationofthePLandtheglottisandtheincreasedtransversediameteroftheLT
7、CoppositetothedeviatedPL・Neuralgiaoccuredwhensuperiorlaryngealnervewaspressedbythehypertrophicsuperiorhorn,thesymptomofwhichcouldbecontrolledbylocalblocktherapyandphysiotherapy.【Keywords]DeviationofglottisSpinningoflarynxThyroidcartilage自1906年Mygind首次报告声门偏斜以來
8、，文献中对偏斜的成因尚有不同见解[1~5]。现对1988〜1998年间随访的45例这类患者，分析其临床特征，探讨其机理。1临床资料及方法45例病例中男性44例，女性1例。年龄16〜75岁,其中16〜30岁8例，31〜45岁23例，46〜60岁8例，＞61岁6例。9例自己发现有喉结偏斜，其余均因咽喉具他疾病就诊吋发现；无1例因喉结偏斜为主诉而就诊；有3例因肥大Z甲状软骨上角
