İntrakordal yağ enjeksiyonu sonrası vokal kordların durumu ve ses kalitesi değerlendirilmesi
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Date
2011
Authors
Ceyhan, Aydın
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı, glottik yetersizlik nedeniyle intrakordal yağ enjeksiyonu (İYE) uygulanan hastalarda vokal kordların durumu ve cerrahinin başarı kriterlerinin araştırılması olarak belirlenmiştir.Bu çalışma Uludağ Üniversitesi Tıp Fakültesi KBB Anabilim Dalı'nda, Mayıs 2009 Mayıs 2011 tarihleri arasındaki 24 aylık süre içerisinde yapılmıştır. Bu süre içerisinde 18 hastaya İYE uygulanmıştır. Ancak çeşitli nedenlerle 11 hasta çalışmaya alınabilmiş, bunun dışında daha önce İYE uygulanan 5 hasta da çalışmanın bir bölümüne dahil edilmiştir. Bu çalışmaya ses kısıklığı ve aspirasyon nedeniyle KBB polikliniğine başvuran ve değerlendirilmelerinin ardından vokal kord paralizisi, sulkus vokalis veya daha önce uygulanmış olan kordektomi nedeniyle glottik yetersizlik saptanan ve İYE uyguladığımız hastalar dahil edilmiştir. Hastalara preoperatif dönemde videolarengostroboskopi (VLS) ve Dr. Speech programı ile ses analizi yapıldı. Tüm hastalara endolarengeal yaklaşımla intrakordal yağ enjeksiyonu uygulandı. Hastalara operasyondan sonra 1. ay, 6. ay, ve 1. yıl da ses analizi ve VLS yapıldı ayrıca postoperatif 1. yılda 14 hastaya boyun enjekte edilen yağın görüntülenebilmesi amacıyla manyetik rezonans (MR) çekildi. Bütün parametreler preoperatif ve postoperatif dönemler için ayrı ayrı incelendi.İYE sonrası ses kısıklığı ve aspirasyon probleminde azalma görülmüş, şikayetlerdeki bu değişim VLS ve ses analizi ile desteklenmiştir. Bu değişim istatistiksel olarak anlamlı bulundu (p<0,05) Postoperatif 1. yıl da çekilen boyun MR da bu cerrahinin etkinliğini görüntüleme yöntemi olarak ortaya koymuştur.Bu değerlendirmeler ışığında intrakordal yağ enjeksiyonunun düşük dereceli glottik yetmezliğin tedavisinde etkin ve başarılı cerrahi yöntem olduğu; objektif ve sübjektif yöntemlerle de kanıtlanabilir olduğu düşüncesindeyiz.
The aim of this study is to determine the criterias for success of intervention in patients who underwent intracordal fat injection (IFI) for glottic insuffiency and to evaluate the status of the vocal cords after surgery.This study was conducted at the department of Otolaryngology of Uludag University between May 2009 and May 2011. Intracordal fat injection was applied to 18 patients totally in this period. However because of some certain problems only 11 of these patients were included in the study group but other 5 patients to whom IFI was applied were also added to some parts of the study.The patients who were admitted to ENT clinic with the complaints of hoarseness and aspiration problems and diagnosed with vocal cord paralysis, sulcus vocalis or glottic insuffiency because of a previous cordectomy who required IFI were all included in the study. All patients were evaluated by using videolaryngostroboscopy (VLS) and computerized voice analysis. All patients underwent intracordal fat injection under endolaryngeal suspension method. Postoperative evaluations were performed at the 1st, the 6th months and at the end of 1 th year by repeated VLS and voice analysis. And 14 of the patients were examined with a magnetic resonance imaging of the neck region. All data concerning preoperative and postoperative periods were analysed individually.As a result, after IFI application the complaints of patients concerning hoarseness and aspiration were decreased and these findings were also coincided with the analysis of voice assesment and VLS. This difference was found to be statistically significant (p<0.05). This study also showed that the efficacy of this surgery might also be evaluated with magnetic resonance imaging of the neck at the end of first year postoperatively.We concluded in the highlights of objective and subjective findings of this study that intracordal fat injection is an effective and successfull surgical intervention for the management of low grade glottic insufficiency.
The aim of this study is to determine the criterias for success of intervention in patients who underwent intracordal fat injection (IFI) for glottic insuffiency and to evaluate the status of the vocal cords after surgery.This study was conducted at the department of Otolaryngology of Uludag University between May 2009 and May 2011. Intracordal fat injection was applied to 18 patients totally in this period. However because of some certain problems only 11 of these patients were included in the study group but other 5 patients to whom IFI was applied were also added to some parts of the study.The patients who were admitted to ENT clinic with the complaints of hoarseness and aspiration problems and diagnosed with vocal cord paralysis, sulcus vocalis or glottic insuffiency because of a previous cordectomy who required IFI were all included in the study. All patients were evaluated by using videolaryngostroboscopy (VLS) and computerized voice analysis. All patients underwent intracordal fat injection under endolaryngeal suspension method. Postoperative evaluations were performed at the 1st, the 6th months and at the end of 1 th year by repeated VLS and voice analysis. And 14 of the patients were examined with a magnetic resonance imaging of the neck region. All data concerning preoperative and postoperative periods were analysed individually.As a result, after IFI application the complaints of patients concerning hoarseness and aspiration were decreased and these findings were also coincided with the analysis of voice assesment and VLS. This difference was found to be statistically significant (p<0.05). This study also showed that the efficacy of this surgery might also be evaluated with magnetic resonance imaging of the neck at the end of first year postoperatively.We concluded in the highlights of objective and subjective findings of this study that intracordal fat injection is an effective and successfull surgical intervention for the management of low grade glottic insufficiency.
Description
Keywords
İntrakordal yağ enjeksiyonu, Videolarengostroboskopi, Ses analizi, Boyun MR, Intracordal fat injection, Videolaryngostroboscopy, Voice analysis, Neck MRI
Citation
Ceyhan, A. (2011). İntrakordal yağ enjeksiyonu sonrası vokal kordların durumu ve ses kalitesi değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.