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滑动气管成形术应用于后天性声门下及上段气管狭窄:犬模型实验研究

Slide tracheoplasty applied to acquired subglottic and upper tracheal stenosis: an experimental study in a canine model.

作者信息

Abdelkafy Wael M, El Atriby Mohamed N, Iskandar Nagy M, Mattox Douglas E, Mansour Kamal A

机构信息

Department of Otolaryngology-Head & Neck Surgery, Suez Canal University, Ismailia, Egypt.

出版信息

Arch Otolaryngol Head Neck Surg. 2007 Apr;133(4):327-30. doi: 10.1001/archotol.133.4.327.

Abstract

OBJECTIVE

To assess the applicability and complications of slide tracheoplasty in the management of subglottic and upper tracheal stenosis in experimental animals.

DESIGN

Subglottic stenosis was induced in 10 dogs by cauterizing the subglottic area and the upper 3 to 4 cm of the trachea. After 21 days, the severity of stenosis ranged from 30% to 60%. The subglottic area was reconstruction with slide tracheoplasty, and the results were evaluated at 4, 12, and 24 weeks postoperatively.

SUBJECTS

Ten mongrel dogs (Canis familiaris) were included in the study, each weighing between 12 and 17 kg.

INTERVENTION

Slide tracheoplasty.

MAIN OUTCOME MEASURE

Patency of the reconstructed segment.

RESULTS

Follow-up examination revealed no airway obstruction in any animal. Examination of the reconstructed segment revealed good healing without granulation tissue and a patent endotracheal lumen in all cases. Histopathological examination of sections taken at the suture line confirmed complete healing without granulation tissue.

CONCLUSIONS

Slide tracheoplasty can be applied successfully to the subglottic area. It offers many advantages in tracheal reconstruction and can be used for the management of acquired subglottic stenosis. The vascularized tracheal cartilage heals without granulation tissue often seen after cartilage interposition grafts. Furthermore, this technique reduces the need for tracheal and laryngeal mobilization for the treatment of longer areas of stenosis.

摘要

目的

评估滑动气管成形术在实验动物声门下及气管上段狭窄治疗中的适用性及并发症。

设计

通过烧灼声门下部区域及气管上段3至4厘米,在10只犬中诱导声门下狭窄。21天后,狭窄程度为30%至60%。采用滑动气管成形术重建声门下部区域,并在术后4周、12周和24周对结果进行评估。

对象

10只杂种犬(家犬)纳入研究,每只体重在12至17千克之间。

干预

滑动气管成形术。

主要观察指标

重建节段的通畅情况。

结果

随访检查显示,所有动物均无气道阻塞。对重建节段的检查显示,所有病例愈合良好,无肉芽组织,气管内管腔通畅。对缝合线处切片的组织病理学检查证实完全愈合,无肉芽组织。

结论

滑动气管成形术可成功应用于声门下部区域。它在气管重建方面具有诸多优势,可用于治疗后天性声门下狭窄。带血管的气管软骨愈合时无软骨间置移植后常见的肉芽组织。此外,该技术减少了治疗较长狭窄区域时气管和喉部的游离需求。

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