Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 120-175, South Korea.
J Pediatr Surg. 2010 Dec;45(12):2317-21. doi: 10.1016/j.jpedsurg.2010.08.024.
BACKGROUND/PURPOSE: The aim of this study was to describe our early experiences with a novel surgical procedure, "slide thyrocricotracheoplasty," for the treatment of high-grade subglottic stenosis in children.
A retrospective analysis was performed in 7 children who underwent slide thyrocricotracheoplasty for high-grade subglottic stenosis from 1996 to 2009.
Three patients were male and four were female. The etiology of subglottic stenosis was congenital (n = 4) or acquired (n = 3). All patients had undergone a tracheostomy before slide thyrocricotracheoplasty. Median age at operation was 16 months (range, 1-25 months). The median follow-up period after definitive operation was 58 months (range, 13-156 months). There was one case requiring debridement and re-anastomosis of slide thyrocricotracheoplasty site because of anastomotic disruption caused by a methicillin-resistant Staphylococcus aureus infection of the cartilage and one case requiring a minor operation to remove granulation tissue. At final follow-up, all patients did not have any airway cannulation with satisfactory functional outcome in terms of breathing and swallowing. All except one were noted to have acceptable vocal function. The patient with unsatisfactory vocal function continued to receive voice rehabilitation treatment.
Slide thyrocricotracheoplasty offers an efficient surgical treatment option with minimal morbidity for high-grade subglottic stenosis in children.
背景/目的：本研究旨在描述我们在一种新的手术方法“滑动甲状软骨气管成形术”治疗儿童重度声门下狭窄方面的早期经验。
对 1996 年至 2009 年间接受滑动甲状软骨气管成形术治疗重度声门下狭窄的 7 例儿童进行回顾性分析。
3 例为男性，4 例为女性。声门下狭窄的病因是先天性（n=4）或后天性（n=3）。所有患者在滑动甲状软骨气管成形术之前均行气管切开术。手术时的中位年龄为 16 个月（范围，1-25 个月）。最终手术治疗后中位随访时间为 58 个月（范围，13-156 个月）。有 1 例因耐甲氧西林金黄色葡萄球菌感染软骨导致吻合口破裂而需要清创和再次吻合滑动甲状软骨气管成形术部位，1 例需要进行小手术切除肉芽组织。最终随访时，所有患者均无需进行任何气道插管，呼吸和吞咽功能均有满意的结果。除 1 例外，所有患者的发音功能均被认为是可接受的。发音功能不满意的患者继续接受语音康复治疗。
滑动甲状软骨气管成形术为儿童重度声门下狭窄提供了一种有效且并发症少的手术治疗选择。
