Gallagher Thomas Q, Hartnick Christopher J
Department of Otolaryngology, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708, USA.
Adv Otorhinolaryngol. 2012;73:31-8. doi: 10.1159/000334296. Epub 2012 Mar 29.
Laryngotracheal reconstruction (LTR) along with cricotracheal resection and thyrotracheal anastomosis has become the standard of care for symptomatic subglottic stenosis in the pediatric age group. Success rates in achieving decannulation or avoiding tracheotomy approach 90%. Fearon and Cotton introduced pediatric LTR in 1972 using cartilage interposition grafting. The procedure has evolved to include a variety of techniques for expanding the laryngotracheal complex to obtain a stable airway of sufficient size for respiration. In this chapter, the authors will describe their single and double-stage technique for LTR highlighting surgical pearls necessary for success.
喉气管重建术(LTR)以及环状气管切除术和甲状腺气管吻合术已成为小儿亚声门下狭窄有症状患者的标准治疗方法。拔管成功率或避免气管切开术的成功率达90%。1972年,费伦(Fearon)和科顿(Cotton)采用软骨植入术引入了小儿LTR。该手术已发展为包括多种扩大喉气管复合体的技术,以获得足够大小的稳定气道用于呼吸。在本章中,作者将描述他们的单阶段和双阶段LTR技术,重点介绍成功所需的手术要点。