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[儿童环状气管切除术治疗声门下狭窄]

[Treatment of subglottis stenosis in children by cricotracheal resection].

作者信息

Monnier P, Lang F, Savary M

机构信息

Service d'ORL & de Chirurgie cervico-faciale, CHU Vaudois, 1011 Lausanne, Suisse, France.

出版信息

Ann Otolaryngol Chir Cervicofac. 2001 Oct;118(5):299-305.

Abstract

Fifty-eight infants and children with a severe subglottic stenosis underwent a partial cricotracheal resection with primary thyrotracheal anastomosis. There were 2 grade II, 40 grade III, and 16 grade IV stenoses according to the Myer-Cotton classification. A 100% subglottic lumen was formed in 34 cases and a better than 80% lumen in 23 cases. Fifty-four of the 58 (93%) patients are presently decannulated; one patient sustained a complete restenosis and three patients with a better than 80% subglottic airway still await decannulation for the following reasons: severe tracheomalacia, bilateral cricoarytenoïd joint fixation and laryngeal malformation with fusion of the vocal cords in each case respectively. Forty-four patients have no exercise intolerance, 8 live fully normally but present a slight exertional dyspnea, one patient with a laryngeal malformation is decannulated but suffers from a severe exertional dyspnea, and 4 patients are still not decannulated. The voice is normal in 20 cases, a slight dysphonia is present in 17, a moderate to severe dysphonia in another 17 and 4 patients are still not decannulated.

摘要

58例患有严重声门下狭窄的婴幼儿接受了部分环状气管切除术并一期进行甲状腺气管吻合术。根据迈尔-科顿分类,其中有2例Ⅱ级狭窄、40例Ⅲ级狭窄和16例Ⅳ级狭窄。34例形成了100%的声门下管腔,23例形成了超过80%的管腔。58例患者中有54例(93%)目前已拔管;1例患者出现完全再狭窄,3例声门下气道超过80%的患者仍未拔管,原因分别为:严重气管软化、双侧环杓关节固定和喉畸形伴声带融合。44例患者无运动不耐受,8例生活完全正常但有轻微运动性呼吸困难,1例患有喉畸形的患者已拔管但有严重运动性呼吸困难,4例患者仍未拔管。20例患者声音正常,17例有轻微发音障碍,另外17例有中度至重度发音障碍,4例患者仍未拔管。

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