Wiatrak B J, Cotton R T
Department of Otolaryngology, University of Michigan, Ann Arbor.
Arch Otolaryngol Head Neck Surg. 1992 Jan;118(1):58-62. doi: 10.1001/archotol.1992.01880010062017.
Numerous techniques for the surgical management of laryngotracheal stenosis in children have been described in the literature. These surgical modalities include endoscopic management and open laryngotracheal reconstruction using costal cartilage grafts for expansion of the stenotic subglottic region. Although tracheal resection with primary reanastomosis for the management of tracheal stenosis is reported frequently in the adult population, children rarely have stenotic lesions that are amenable to this particular technique. Laryngotracheal stenosis in children most commonly involves the subglottis. This makes tracheal resection with anastomosis technically difficult to perform, due to the close proximity of the vocal cords. We have found a subpopulation of children at our institution with high tracheal stenoses, with minimal lower subglottic involvement, who were amenable to tracheal resection with primary anastomosis. We review our experience with this technique. The indications for this surgical modality in children are discussed, as well as the surgical technique.
文献中已描述了多种儿童喉气管狭窄的外科治疗技术。这些手术方式包括内镜治疗以及使用肋软骨移植进行开放性喉气管重建，以扩大狭窄的声门下区域。尽管在成人中，气管切除并一期吻合治疗气管狭窄的报道较为常见，但儿童很少有适合这种特定技术的狭窄病变。儿童喉气管狭窄最常累及声门下区。由于声带位置接近，这使得气管切除并吻合在技术上难以实施。我们发现在我们机构中有一部分患有高位气管狭窄且声门下区受累最小的儿童，他们适合进行气管切除并一期吻合。我们回顾了我们在这项技术上的经验。讨论了这种手术方式在儿童中的适应证以及手术技术。
