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儿童孤立性后声门狭窄采用内镜下后路移植进行单阶段喉气管重建——我们的做法。

Single stage laryngotracheal reconstruction using endoscopic posterior grafting in isolated posterior glottic stenosis in children - how we do it.

作者信息

Bajaj Y, Tweedie D, Ifeacho S, Hewitt R, Lloyd-Thomas A, Albert D M

机构信息

Department of Paediatric Otolaryngology, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH, United Kingdom.

出版信息

Int J Pediatr Otorhinolaryngol. 2011 May;75(5):624-6. doi: 10.1016/j.ijporl.2011.01.034. Epub 2011 Feb 27.

DOI:10.1016/j.ijporl.2011.01.034
PMID:21362576
Abstract

OBJECTIVE

Posterior glottic stenosis is a well recognised though rare condition. A wide range of treatment options have been proposed including endoscopic laser techniques and open techniques with grafting. The objective of this study was to present our experience of single stage laryngotracheal reconstruction with endoscopic technique of placement of posterior graft in isolated posterior glottic stenosis.

METHODS

This study was conducted at the Department of Paediatric Otolaryngology at Great Ormond Street Hospital, London. The senior authors (ALT, DMA) were involved in the management of two children with isolated posterior glottic stenosis operated on as single stage reconstruction.

RESULTS

The two children in this small series had isolated posterior glottic stenosis. The aetiology in both the cases was previous prolonged intubation. Both patients underwent a successful placement of the posterior graft endoscopically, though it was a challenging task because of space constraints. None of these children required an intra-operative or post-operative tracheostomy. There were no complications in these patients. At follow up endoscopic examinations, both these patients have had their airway widened successfully.

CONCLUSION

Single stage laryngotracheal reconstruction with endoscopic placement of posterior graft in cases with isolated posterior glottic stenosis is a good alternative to open surgical techniques, although is technically a challenging procedure.

摘要

目的

声门后狭窄是一种虽已广为人知但较为罕见的病症。人们已经提出了多种治疗方案,包括内镜激光技术和带移植术的开放技术。本研究的目的是介绍我们在内镜下将后部移植物置入孤立性声门后狭窄进行单阶段喉气管重建的经验。

方法

本研究在伦敦大奥蒙德街医院儿科耳鼻喉科进行。资深作者(ALT、DMA)参与了对两名患有孤立性声门后狭窄的儿童进行单阶段重建手术的管理。

结果

在这个小系列中的两名儿童患有孤立性声门后狭窄。两例病因均为既往长期插管。两名患者均在内镜下成功置入后部移植物,不过由于空间受限,这是一项具有挑战性的任务。这些儿童均无需术中或术后气管切开术。这些患者均未出现并发症。在随访内镜检查中,这两名患者的气道均成功增宽。

结论

在内镜下将后部移植物置入孤立性声门后狭窄病例中进行单阶段喉气管重建,是开放手术技术的一种良好替代方案,尽管在技术上是一项具有挑战性的手术。

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