喉软化症手术：一家三级儿科医院的系列研究。
Laryngomalacia surgery: a series from a tertiary pediatric hospital.
出版信息
Braz J Otorhinolaryngol. 2012 Dec;78(6):99-106. doi: 10.5935/1808-8694.20120041.
UNLABELLED
Laryngomalacia is the condition responsible for 75% of the cases of stridor in children aged up to 30 months, in which there is supraglottic collapse during inhalation. Inspiratory stridor is a characteristic telltale. As many as 20% of the patients are severely affected and require surgery. Supraglottoplasty is the procedure of choice and the presence of comorbidities is the most relevant prognostic factor for surgery success.
OBJECTIVE
To describe a series in a tertiary pediatric hospital, its success rates, and surgery prognostic factors.
METHOD
This retrospective cohort study enrolled 20 patients submitted to supraglottoplasty between July 2007 and May 2011.
RESULTS
Thirteen (65%) patients were males; mean age at the time of the procedure was 6.32 months. Endoscopic examination showed that 12 subjects had combined forms of laryngomalacia, 40% had associated pharyngomalacia, and three also had tracheomalacia. Thirteen subjects had isolated laryngomalacia and seven had gastroesophageal reflux disease. Fifteen (75%) patients underwent aryepiglottic fold resection. After the procedure, eleven patients were asymptomatic and two required tracheostomy. Presence of comorbidities was the strongest predictor of unfavorable postoperative outcome (p = 0.034).
CONCLUSION
Supraglottoplasty is a safe therapeutical procedure for select patients with laryngomalacia.
背景
先天性喉软化症是导致 30 月龄以下儿童 75%喘鸣的原因，其在吸气时会出现会厌上塌。吸气性喘鸣是其特征性表现。多达 20%的患者病情严重，需要手术。杓会厌皱襞切除术是首选术式，并存疾病是手术成功的最相关预后因素。
目的
描述一家三级儿科医院的病例系列，其成功率及手术预后因素。
方法
本回顾性队列研究纳入了 2007 年 7 月至 2011 年 5 月间接受杓会厌皱襞切除术的 20 例患者。
结果
13 例（65%）患者为男性；手术时的平均年龄为 6.32 个月。内镜检查显示 12 例存在混合性先天性喉软化症，40%存在咽成形术后软化，3 例还存在气管软化。13 例存在单纯性先天性喉软化症，7 例存在胃食管反流病。15 例（75%）患者行杓状软骨后联合切除术。术后，11 例患者无症状，2 例需要行气管切开术。并存疾病是术后不良结局的最强预测因素（p=0.034）。
结论
对于选择的先天性喉软化症患者，杓会厌皱襞切除术是一种安全的治疗方法。
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