Sittel C
Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Kriegsbergstrasse 60, Stuttgart, Germany.
HNO. 2012 Jul;60(7):568-72. doi: 10.1007/s00106-012-2508-z.
Subglottic stenosis of congenital origin or acquired within the first 12 months of life are challenging in many aspects. Surgical reconstruction is difficult due to the small anatomic dimensions. Tracheostomy is an additional risk factor attributing to mortality and should be avoided, if possible. In this paper, the most important types of subglottic stenosis in the first year of life are discussed. Conservative, endoscopic, and open surgical treatment options are presented and evaluated. Laryngotracheal reconstruction with autologous thyroid cartilage is the treatment of choice for the majority of significant subglottic stenosis cases in this age group. This technique is comparatively less invasive, versatile, and allows all options for open reconstruction using other techniques in case of recurrent stenosis. Subglottic stenosis in early infancy requires expertise and experience in diagnosis and treatment. Considering the limited incidence, these cases should be managed in a referral center.
先天性或在生命的头12个月内获得的声门下狭窄在许多方面都具有挑战性。由于解剖尺寸小，手术重建很困难。气管切开术是导致死亡的另一个风险因素，应尽可能避免。本文讨论了生命第一年最重要的声门下狭窄类型。介绍并评估了保守、内镜和开放手术治疗方案。自体甲状腺软骨喉气管重建术是该年龄组大多数严重声门下狭窄病例的首选治疗方法。该技术创伤相对较小，用途广泛，并且在复发狭窄的情况下允许使用其他技术进行所有开放重建选择。婴儿早期的声门下狭窄需要诊断和治疗方面的专业知识和经验。考虑到发病率有限，这些病例应在转诊中心进行管理。
