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小儿部分环状气管切除术:一种环状软骨后吻合的新技术。

Pediatric partial cricotracheal resection: a new technique for the posterior cricoid anastomosis.

作者信息

Boseley Mark E, Hartnick Christopher J

机构信息

Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA.

出版信息

Otolaryngol Head Neck Surg. 2006 Aug;135(2):318-22. doi: 10.1016/j.otohns.2006.03.022.

Abstract

OBJECTIVE

Partial cricotracheal resection has become a more popular procedure in the pediatric population as a treatment for severe subglottic stenosis. We describe a new technique for the posterior cricoid anastomosis.

STUDY DESIGN AND SETTING

This is a case series of 4 pediatric patients with a Myer-Cotton grade III or IV subglottic stensosis.

SETTING

Tertiary care hospital with a pediatric intensive care unit.

RESULTS

All 4 patients were decannulated and there were no observed complications to include posterior mucosal dehiscence and/or recurrent laryngeal nerve injury.

CONCLUSIONS

Placing sutures through the cricoid cartilage is technically less difficult than previously described techniques for treating subglottic stenosis near the undersurface of the true vocal folds and affords a more stable posterior mucosal suture line.

SIGNIFICANCE

This technique provides a surgical means to treat high subglottic stenosis that closely approximates the true vocal folds by enabling a stable posterior mucosa to mucosa apposition.

EBM RATING

Grade C-4.

摘要

目的

作为治疗严重声门下狭窄的一种方法,部分环状气管切除术在儿科人群中已成为一种更常用的手术。我们描述了一种环状软骨后部吻合术的新技术。

研究设计与背景

这是一个包含4例迈耶-科顿III级或IV级声门下狭窄儿科患者的病例系列。

背景

设有儿科重症监护病房的三级护理医院。

结果

所有4例患者均拔管,未观察到包括后部黏膜裂开和/或喉返神经损伤在内的并发症。

结论

与之前描述的在真声带下表面附近治疗声门下狭窄的技术相比,通过环状软骨放置缝线在技术上难度较小,并且能提供更稳定的后部黏膜缝合线。

意义

该技术提供了一种手术方法,通过实现稳定的后部黏膜对黏膜贴合来治疗接近真声带的高位声门下狭窄。

循证医学等级

C-4级。

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