Rizzi Mark D, Thorne Marc C, Zur Karen B, Jacobs Ian N
Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Otolaryngol Head Neck Surg. 2009 Mar;140(3):348-53. doi: 10.1016/j.otohns.2008.11.035.
To describe our outcomes after laryngotracheal reconstruction that required posterior costal cartilage grafting focused on decannulation rates and complications.
Case series with chart review.
Charts were reviewed on 58 patients. Operation specific and overall decannulation rates were determined. Complications were reviewed and correlated with technique of graft placement. Available voice outcomes were reviewed.
Forty-eight patients were included. There was no statistically significant correlation between degree of stenosis and rate of decannulation. The overall decannulation rate, regardless of number of surgeries performed, was 96 percent. The relative risk for complications was higher among children who had a sutured versus a sutureless flanged posterior graft (RR = 2.5, P < 0.01). The most common voice anomaly was supraglottic compression.
Operation-specific decannulation rates are not significantly different with increasing disease severity, although the power to detect small differences in this study is low. Sutureless graft placement is associated with a lower complication rate. Supraglottic compression is a common postoperative compensatory vocal behavior and may correlate with disease severity.
描述我们在需要进行后肋软骨移植的喉气管重建术后的结果，重点关注拔管率和并发症。
病例系列研究并进行图表回顾。
回顾了58例患者的病历。确定了手术特定和总体拔管率。对并发症进行了回顾，并与移植物放置技术相关联。对现有的嗓音结果进行了回顾。
纳入了48例患者。狭窄程度与拔管率之间无统计学显著相关性。无论进行手术的次数如何，总体拔管率为96%。在采用缝合式与无缝合缘后移植物的儿童中，并发症的相对风险更高（相对风险=2.5，P<0.01）。最常见的嗓音异常是声门上压迫。
尽管本研究检测微小差异的能力较低，但随着疾病严重程度的增加，手术特定拔管率并无显著差异。无缝合移植物放置与较低的并发症发生率相关。声门上压迫是一种常见的术后代偿性发声行为，可能与疾病严重程度相关。
