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儿童内镜气道管理

Endoscopic airway management in children.

作者信息

Rutter Michael J, Cohen Aliza P, de Alarcon Alessandro

机构信息

Division of Pediatric Otolaryngology - Head and Neck Surgery, Aerodigestive and Sleep Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229-3039, USA.

出版信息

Curr Opin Otolaryngol Head Neck Surg. 2008 Dec;16(6):525-9. doi: 10.1097/moo.0b013e3283184479.

Abstract

PURPOSE OF REVIEW

To discuss the current status of endoscopic airway surgery in children.

RECENT FINDINGS

More refined endoscopic instruments have been introduced, including balloon dilators, powered debriders, lasers with more exact modes of delivery, and innovative suspension laryngoscopes. The use of balloon dilatation for primary management of acquired subglottic stenosis is promising. Microdebriders are now considered a viable option to the CO2 laser for the management of a number of airway diseases. Knowledge regarding supraglottoplasty continues to evolve. Endoscopic vocal cord lateralization is being successfully used at some centers for the management of bilateral vocal cord paralysis. The da Vinci Surgical Robot (Intuitive Surgical, Inc., Sunnyvale, California, USA) has been introduced to facilitate endoscopic laryngeal cleft repair.

SUMMARY

Endoscopic airway surgery is presently regaining its early (1960s) popularity. This trend can be attributed to the availability of new and more sophisticated endoscopic instrumentation, the adjunctive use of new pharmaceuticals, and the realization that open and endoscopic techniques can often be used in a complementary fashion.

摘要

综述目的

探讨儿童气道内镜手术的现状。

最新发现

已引入了更为精细的内镜器械,包括球囊扩张器、动力性清创器、具有更精确发射模式的激光以及创新性悬吊喉镜。球囊扩张术用于后天性声门下狭窄的初始治疗前景广阔。对于多种气道疾病的治疗,微型清创器现已被视为二氧化碳激光的一种可行替代方案。关于声门上成形术的知识不断发展。内镜下声带外移术在一些中心已成功用于双侧声带麻痹的治疗。已引入达芬奇手术机器人(美国加利福尼亚州森尼韦尔市直观外科公司)以辅助内镜下喉裂修复。

总结

气道内镜手术目前正重新获得其在20世纪60年代早期的普及程度。这一趋势可归因于新型且更先进的内镜器械的可得性、新药物的辅助使用以及认识到开放手术和内镜技术常常可互补使用。

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