Sztanó B, Torkos A, Rovó L
Department of Otolaryngology Head and Neck Surgery, University of Szeged, 111 Tisza L krt, 6723 Szeged, Hungary.
Int J Pediatr Otorhinolaryngol. 2010 Feb;74(2):212-5. doi: 10.1016/j.ijporl.2009.11.007. Epub 2009 Dec 8.
Laryngeal web in the anterior commissure is a rare congenital anomaly often leading to severe dyspnea. Endoscopic procedures based on a simple transsection in these cases may worsen the condition because vocal folds have a tendency for fibrosis and granulation tissue formation after surgical interventions. Thus the traditional treatment of choice is the demanding, externally performed laryngotracheal reconstruction generally with a rib cartilage graft and longer period of stenting. This report presents the successful endoscopic management of a congenital laryngeal web in a 2-year-old boy, who previously underwent an uneffective scar laser transsection that led to excessive glotto-subglottic refibrosis. After the CO(2)-laser transsection the authors applied Mitomycin-C and inserted a combined silicon stent by extra-endolaryngeal technique. After the removal of the stent the patient could be decannulated and his voice improved. The application of these minimally invasive endoscopic techniques was successful, hence it may be an effective alternative treatment option for laryngeal webs.
前联合处的喉蹼是一种罕见的先天性异常，常导致严重呼吸困难。在这些病例中，基于简单横断术的内镜手术可能会使病情恶化，因为手术干预后声带容易出现纤维化和肉芽组织形成。因此，传统的治疗选择是要求较高的外部喉气管重建术，通常采用肋软骨移植和较长时间的支架置入。本报告介绍了一名2岁男孩先天性喉蹼的成功内镜治疗，该男孩此前接受了无效的瘢痕激光横断术，导致声门-声门下过度再纤维化。在二氧化碳激光横断术后，作者应用了丝裂霉素-C，并通过喉内技术插入了一个联合硅胶支架。支架取出后，患者可以拔管，声音也有所改善。这些微创内镜技术的应用是成功的，因此它可能是喉蹼的一种有效的替代治疗选择。
