Lichtenberger G, Sittel C
Klinik für Hals, Nasen-, Ohrenkranke, Kopf- und Halschirurgie, Szent Rókus Krankenhaus und Institutionen, Gyulai P. u. 2., 1085, Budapest, Ungarn.
HNO. 2007 Aug;55(8):620-4. doi: 10.1007/s00106-006-1492-6.
In the reconstruction of laryngotracheal stenosis, the exact localization of the level of the stenosis in relation to the cricoid arch is of paramount importance. This report describes an easy, fast and reliable technique for projecting stenotic segments of the subglottic trachea onto the tracheal front wall.
Directly before the reconstructive procedure, the stenosis is visualized using microlaryngoscopy. An endo-extralaryngeal needle-carrier is used to drive a suture from the inside through the skin. This takes the surgeon directly to the anterior tracheal wall at the exact level of the upper margin of the stenotic segment.
This technique has been used in 15 cases, allowing the correct identification of the stenosis in every case. Subjectively, there was a gain of time as well as of the surgeon's confidence in this critical part of the procedure. The transcutaneous identification of a laryngotracheal stenosis using the Lichtenberger endo-extralaryngeal suture technique requires a minimum of additional time. We recommend this technique for routine use whenever an open approach for airway reconstruction of the subglottic larynx or proximal trachea is to be performed.
在喉气管狭窄重建术中，狭窄部位相对于环状软骨弓的精确位置至关重要。本报告描述了一种将声门下气管狭窄段投影到气管前壁的简便、快速且可靠的技术。
在重建手术即将开始前，通过显微喉镜观察狭窄情况。使用喉内外针持器从内部将缝线穿过皮肤。这能使外科医生直接到达狭窄段上缘精确水平处的气管前壁。
该技术已应用于15例患者，每例均能正确识别狭窄部位。主观上，在手术的这一关键部分节省了时间，增强了外科医生的信心。使用利希滕贝格喉内外缝线技术经皮识别喉气管狭窄所需额外时间最少。我们建议，每当要对声门下喉或近端气管进行气道重建的开放手术时，常规使用该技术。
