Objective To investigate the efficacy and operation strategy of CO2laser treatment of patients with vocal cord leukoplakia under phonomicrosurgery.Methods Forty-five patients were treated with CO2 laser phonomicrosurgery of mucosal epitheliumablation,mucosal stripping and partial resection of vocal cord,respectively.Results There were 24 vocal cord leukoplakia cases without dysplasia,13 cases with mild dysplasia(LIN1) and 8 cases with moderate to severe dysplasia(LIN2).Three cases recurred postoperatively and accepted twice or more operations successively.One case occurred canceration.Conclusion The CO2 laser phonomicrosurgery is a valuable treatment for patients with vocal cord leukoplakia.It has advantages of less trauma,quicker recovery and difficult to recurrence.However,the cases with dysplasia should be followed up closely.%目的 探讨CO2激光喉显微手术治疗声带白斑的临床疗效及手术策略.方法 在显微支撑喉镜下,对45例声带白斑患者分别采用CO2激光黏膜表皮剥脱术、黏膜下切除术或声带部分切除术治疗.结果 声带黏膜上皮角化不伴非典型增生(24例)以及伴有轻度不典型增生(13例)均全部治愈.角化伴中度-重度不典型增生(8例)治愈4例,其中3例复发,并相继进行2次或多次手术；1例癌变.45例术后均未出现呼吸困难、出血等严重并发症.结论 CO2激光喉显微手术治疗声带白斑疗效显著,具有创伤小、术后嗓音恢复快、不易复发等优点；对病理检查提示有异型增生者需密切随诊观察.
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