Cotton R T, Mortelliti A J, Myer C M
Department of Otolaryngology and Maxillofacial Surgery, University of Cincinnati, College of Medicine, Children's Hospital Medical Center, OH 45229.
Arch Otolaryngol Head Neck Surg. 1992 Oct;118(10):1023-7. doi: 10.1001/archotol.1992.01880100013005.
Four-quadrant division of the cricoid cartilage is a relatively new technique of laryngotracheal reconstruction. Division of the lateral walls of the cricoid cartilage, with or without placement of autogenous cartilage grafts, allows for increased expansion of the subglottic lumen. Between October 1, 1986, and January 1, 1990, 185 laryngotracheal reconstructions were performed at our institution. During that time, 31 four-quadrant division laryngotracheal reconstruction procedures were performed in 29 patients (mean age at surgery, 5 years 5 months). Grade 3 or 4 laryngeal stenosis existed preoperatively in 72% (22/31) of cases. The initial decannulation rate after four-quadrant division laryngotracheal reconstruction was 58% (18/31). Of 11 patients requiring revision surgery after four-quadrant division laryngotracheal reconstruction, four were eventually decannulated, for an overall decannulation rate of 76% (22/29). The indications, technique, results, and potential complications of four-quadrant division of the cricoid cartilage in laryngotracheal reconstruction are discussed.
环状软骨四象限切开术是一种相对较新的喉气管重建技术。切开环状软骨侧壁，无论是否植入自体软骨移植物，均可使声门下腔扩大。1986年10月1日至1990年1月1日期间，我院共进行了185例喉气管重建手术。在此期间，对29例患者（手术平均年龄5岁5个月）实施了31例环状软骨四象限切开喉气管重建手术。术前72%（22/31）的病例存在3级或4级喉狭窄。环状软骨四象限切开喉气管重建术后的初始拔管率为58%（18/31）。在31例环状软骨四象限切开喉气管重建术后需要翻修手术的11例患者中，4例最终成功拔管，总体拔管率为76%（22/29）。本文讨论了环状软骨四象限切开术在喉气管重建中的适应证、技术、结果及潜在并发症。
