Toynton S C, Saunders M W, Bailey C M
Department of Otolaryngology, Head and Neck Surgery, Derriford Hospital, Plymouth, UK.
J Laryngol Otol. 2001 Jan;115(1):35-8. doi: 10.1258/0022215011906966.
A retrospective review of the notes of 100 consecutive patients who had undergone aryepiglottoplasty for laryngomalacia, at Great Ormond Street Hospital for Children, was undertaken. Fifty-six were male, 44 female and 47 were under three months of age. Indications for surgery were oxygen desaturation below 92 per cent and feeding difficulties causing failure to thrive. Forty-seven patients had other pathology contributing to their airway compromise or feeding problems. Improvement in stridor after one month was achieved in 86/91 (94.5 per cent) being abolished completely in 50/91 (55 per cent). Of the 25 per cent of patients whose symptoms took more than one week to resolve, 16/22 (63.6 per cent) were later found to have a serious neurological condition. Feeding was improved in 42 of 58 patients (72.4 per cent) who had a pre-operative feeding difficulty. The complication rate was low, with only five out of 86 (10 per cent) experiencing initial worsening of the airway and six per cent having aspiration of early feeds before improvement occurred. Endoscopic aryepiglottoplasty remains the operation of choice for patients with severe laryngomalacia, however, in the presence of neurological disease surgery is less likely to be successful.
对伦敦大奥蒙德街儿童医院连续100例因喉软化症接受杓会厌襞成形术的患者病历进行了回顾性研究。其中56例为男性，44例为女性，47例年龄在3个月以下。手术指征为氧饱和度低于92%以及因喂养困难导致发育不良。47例患者存在其他导致气道受压或喂养问题的病理情况。86/91（94.5%）的患者在术后1个月喘鸣得到改善，其中50/91（55%）完全消失。在症状持续超过一周才缓解的25%的患者中，16/22（63.6%）后来被发现患有严重神经系统疾病。58例术前存在喂养困难的患者中，42例（72.4%）的喂养情况得到改善。并发症发生率较低，86例中只有5例（10%）出现气道最初恶化，6%的患者在情况改善前出现早期喂养误吸。内镜下杓会厌襞成形术仍然是重度喉软化症患者的首选手术方式，然而，在存在神经系统疾病的情况下，手术成功的可能性较小。
