Zalzal George H, Collins William O
Department of Pediatric Otolaryngology-Head and Neck Surgery, Children's National Medical Center, 111 Michigan Avenue, N.W., George Washington University, Washington, DC 20010, USA.
Int J Pediatr Otorhinolaryngol. 2005 Mar;69(3):305-9. doi: 10.1016/j.ijporl.2004.10.009. Epub 2004 Dec 8.
Although laryngomalacia is a common cause for infantile stridor, few patients eventually go on to require surgical intervention. When surgery is required, the location of tissue excised may vary depending on the endoscopic findings, but only two methods of tissue excision are described-cold knife excision and carbon dioxide laser. We present our experience of using the microdebrider to excise tissue during supraglottoplasty.
Over the last 12 months, patients were identified who had undergone supraglottoplasty, and their final outcomes with regards to resolution of stridor, cor pulmonale, and/or failure to thrive were assessed. A description of the indications for supraglottoplasty and the actual technique utilizing the microdebrider is included.
Five patients were identified as having undergone a microdebrider-assisted supraglottoplasty. All five had resolution of their stridor following surgery. No new complications such as aspiration or supraglottic stenosis were identified. No revision surgeries were required. The microdebrider was used to trim the aryepiglottic folds and/or redundant arytenoid mucosa in all cases.
The microdebrider appears to be a safe and effective tool to remove redundant tissue during supraglottoplasty.
尽管喉软化是婴儿喘鸣的常见原因，但最终需要手术干预的患者很少。当需要手术时，切除组织的位置可能因内镜检查结果而异，但目前仅描述了两种组织切除方法——冷刀切除和二氧化碳激光。我们介绍了在声门上成形术中使用微型切割器切除组织的经验。
在过去12个月中，确定接受声门上成形术的患者，并评估他们在喘鸣、肺心病和/或发育不良方面的最终结果。包括声门上成形术的适应症描述以及使用微型切割器的实际技术。
确定有5例患者接受了微型切割器辅助声门上成形术。所有5例患者术后喘鸣均得到缓解。未发现新的并发症，如误吸或声门上狭窄。无需再次手术。在所有病例中，微型切割器均用于修剪杓会厌襞和/或多余的杓状软骨黏膜。
微型切割器似乎是声门上成形术中切除多余组织的一种安全有效的工具。
