Schröder U, Schönweiler R, Wollenberg B, Gehrking E
HNO, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Alle 160, 23538 Lübeck.
HNO. 2008 Apr;56(4):467-70. doi: 10.1007/s00106-008-1704-3.
Total aspiration is a rare complication after extended laser surgery for laryngeal cancer with adjuvant radiotherapy.
Two patients with long-standing total aspiration after laser surgery with radiotherapy despite intensified swallowing therapy were treated with an extended medialization thyroplasty.
Postoperatively, both patients were able to swallow food and liquids without aspiration. One patient no longer has a gastrostomy tube and has been free from aspiration with normal oral food intake for 3 years. The second patient, with a tiny mucosal scar perforation, developed an abscess 2 months after surgery and needed revision surgery, with a subsequent return of aspiration.
The second patient's complication stresses the significance of an intact endolaryngeal scar because of the well-known prolonged healing of mucosa in the irradiated larynx. In our opinion, the potential benefits of medialization thyroplasty outweigh the risk of significant complications, especially after irradiation.
全喉误吸是喉癌扩大激光手术后辅助放疗罕见的并发症。
两名患者在接受激光手术联合放疗后，尽管吞咽治疗强化，但仍长期存在全喉误吸，接受了扩大的甲状软骨内移术治疗。
术后，两名患者均能吞咽食物和液体而无误吸。一名患者不再需要胃造瘘管，3年来正常经口进食且无误吸。第二名患者有微小的黏膜瘢痕穿孔，术后2个月发生脓肿，需要再次手术，随后又出现误吸。
第二名患者的并发症强调了喉内瘢痕完整的重要性，因为已知放疗后喉部黏膜愈合时间延长。我们认为，甲状软骨内移术的潜在益处超过了严重并发症的风险，尤其是在放疗后。
