Chen W, Chi R, Liu W
Tangdu Hospital, Fourth Military Medical University, Xi'an.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 1997 Oct;32(5):302-4.
In order to improve the curative effects of laryngotracheal stenosis, 261 patients treated for laryngotracheal stenosis during the last twenty years were retrospectively reviewed. Glottic reconstruction, fence-form laryngotracheal reconstruction and laryngotracheotomy with autogenous tissue or hydroxylapatite rings were selectively used for one-stage reconstruction. Our results demonstrated that among 261 patients, 9 failed in decannulation, 5 were lost for follow-up, 247 (94.6%) patients were successfully decannulated. Among 192 patients followed-up from 1 to 18 years, 4 had restenosis 3 years after operation, 3 were successfully retreated and 10 failed. 182 (94.7%) patients had stable airways. It is concluded that there was no fixed treatment for laryngotracheal stenosis. The choice of surgical procedure and grafting must be decided on the pathologic condition of the larynx and trachea. The advantages of fence-form laryngotracheal reconstruction are simple technique and good result. Reconstruction with combined bipedicled myocutaneous flap and costal cartilage or artificial materials are better for severe laryngotracheal stenosis and large tracheal defect. The usage of stent is important for laryngotracheal reconstraction.
为提高喉气管狭窄的治疗效果，对过去20年中治疗的261例喉气管狭窄患者进行了回顾性研究。一期重建选择性采用声门重建、栅栏状喉气管重建以及自体组织或羟基磷灰石环行喉气管造口术。结果显示，261例患者中，9例拔管失败，5例失访，247例（94.6%）成功拔管。在192例随访1至18年的患者中，4例术后3年出现再狭窄，3例再次治疗成功，10例失败。182例（94.7%）患者气道稳定。结论是，喉气管狭窄没有固定的治疗方法。手术方式和移植材料的选择必须根据喉和气管的病理状况来决定。栅栏状喉气管重建技术简单、效果良好。联合双蒂肌皮瓣和肋软骨或人工材料重建对严重喉气管狭窄和较大气管缺损效果更佳。支架的使用对喉气管重建很重要。
