Myssiorek D, Madnani D, Delacure M D
Department of Otolaryngology and Communicative Disorders, The Long Island Jewish Medical Center, 270-05 76th Ave., New Hyde Park, NY 11040, USA.
Otolaryngol Head Neck Surg. 2001 Oct;125(4):370-3. doi: 10.1067/mhn.2001.118690.
The surgical excision of benign submucosal lesions of the larynx can be performed using a variety of techniques including direct laryngoscopy and external approaches. We propose that small submucosal lesions of the larynx can be removed via the external approach without a tracheotomy.
Retrospective chart review.
Six patients at The Long Island Jewish Medical Center and at the New York University School of Medicine underwent an external approach for the removal of benign submucosal laryngeal lesions without tracheotomies. Lesions included a mixed laryngopyocele, an internal laryngopyocele, a mixed laryngocele, a paraganglioma, a neurilemmoma and a lymphoma. Follow-up ranged from 1 to 9 years.
All patients were female with an average age of 72. No patient required a tracheotomy. One patient remained intubated for 24 hours postoperatively to ensure an adequate airway. Mild dysphagia was noted in all patients, but it was short-lived and did not require alternate methods of alimentation. There have been no recurrences of disease.
The external approach without tracheotomy allows for good exposure with minimal functional disability for the removal of benign submucosal lesions of the larynx.
喉良性黏膜下病变的手术切除可采用多种技术,包括直接喉镜检查和外部入路。我们提出,喉小黏膜下病变可通过外部入路切除,无需气管切开术。
回顾性病历审查。
长岛犹太医疗中心和纽约大学医学院的6例患者接受了外部入路切除喉良性黏膜下病变,未行气管切开术。病变包括混合性喉气囊肿、内喉气囊肿、混合性喉囊肿、副神经节瘤、神经鞘瘤和淋巴瘤。随访时间为1至9年。
所有患者均为女性,平均年龄72岁。无一例患者需要气管切开术。1例患者术后插管24小时以确保气道通畅。所有患者均出现轻度吞咽困难,但持续时间短,无需替代营养方法。无疾病复发。
无需气管切开术的外部入路可实现良好的暴露,切除喉良性黏膜下病变时功能残疾最小。