O'Grady K F, Irish J C, Doyle D J, Gullane P, Butany J
Department of Otolaryngology, Toronto Hospital, University of Toronto, Canada.
Laryngoscope. 1999 Mar;109(3):419-24. doi: 10.1097/00005537-199903000-00015.
To investigate the effects of medialization laryngoplasty on laryngeal airway resistance at various clinically relevant flow rates.
This study was conducted using a total of 13 laboratory experiments. Two of the experiments were used to validate the cadaveric model employed. Eleven experiments were used to quantify airway resistance relative to increasing medialization laryngoplasty stent size.
With autopsy consent the authors obtained 13 consecutive and anatomically complete larynges for experimentation. A thyrotomy window measuring 8 x 6 mm was made on the left side of the thyroid cartilage. A #4 laryngeal mask was secured to the pharyngeal airway with sutures. Eleven experiments were conducted at the same flow rates using increasingly larger stents from 1 mm to 11 mm in size. Using the Bernoulli equation, the pressure measured at the proximal end of the laryngeal mask is representative of the pressure drop across the airway. The experimental model was validated in two experiments using flow rates between 5 and 50 L/min and stents measured at 5, 10, 15, and 20 mm.
Average results from the 11 experiments indicate that at increasing levels of medialization, from 0 to 11 mm, there is essentially the same pressure drop across the larynx at a given flow rate.
At physiologic airflow rates in a cadaveric model, medialization laryngoplasty implants of 11 mm or less seem to have no obvious effect on airway resistance.
研究在各种临床相关流速下，喉内移成形术对喉气道阻力的影响。
本研究共进行了13项实验室实验。其中两项实验用于验证所采用的尸体模型。十一项实验用于量化相对于喉内移成形术支架尺寸增加的气道阻力。
经尸体解剖同意，作者获取了13个连续且解剖结构完整的喉部用于实验。在甲状软骨左侧制作一个8×6毫米的甲状软骨切开窗口。用缝线将4号喉罩固定于咽气道。使用尺寸从1毫米到11毫米逐渐增大的支架，在相同流速下进行了十一项实验。利用伯努利方程，在喉罩近端测得的压力代表气道两端的压力降。在两项实验中，使用5至50升/分钟的流速以及尺寸为5、10、15和20毫米的支架对实验模型进行了验证。
十一项实验的平均结果表明，在0至11毫米的内移程度增加时，在给定流速下喉部两端的压力降基本相同。
在尸体模型的生理气流速率下，11毫米及以下的喉内移成形术植入物似乎对气道阻力没有明显影响。
