Fiorelli Alfonso, Mazzone Salvatore, Mazzone Adriano, Santini Mario
Thoracic Surgery Unit, Second University of Naples, Naples, Italy.
Interact Cardiovasc Thorac Surg. 2013 Sep;17(3):591-3. doi: 10.1093/icvts/ivt226. Epub 2013 May 19.
We report a case of granulations that complicated subglottic stent placement and completely destroyed vocal folds with luminal stent obstruction. A microbial aetiology significantly contributed to the occurrence of granulations associated with mechanical irritation. The granulations were successfully resected using a digital AcuBlade laser system, a new generation of CO2 laser used in otorhinolaryngology, particularly in vocal cord disease. It permitted a precise control of the scan line between vocal fold and granulation for several reasons. The scan line was completely electronic and integrated in the scanner. The sweep in speed was constant and the energy distribution was uniform along the entire length of the time. The interpulse pause was of ∼1 ms, allowing the tissue cooling with reduction of thermal spread and quicker healing support. The result was the radical excision of granulations without injuring vocal folds. The respiratory function was restored and no other treatments such as arytenoidectomy or cordectomy associated with the alteration of phonatry function were required. No intraoperative or/and postoperative complications were registered and the patient was discharged 7 days after the procedure.
我们报告了一例因声门下支架置入并发肉芽组织形成，导致声门完全破坏并伴有管腔内支架阻塞的病例。微生物病因在与机械刺激相关的肉芽组织形成中起了重要作用。使用数字AcuBlade激光系统成功切除了肉芽组织，这是新一代用于耳鼻咽喉科，特别是声带疾病的二氧化碳激光。由于多种原因，它能够精确控制声带与肉芽组织之间的扫描线。扫描线完全电子化并集成在扫描仪中。扫描速度恒定，能量分布在整个时间长度上均匀。脉冲间歇约为1毫秒，可使组织冷却，减少热扩散并促进更快愈合。结果是在不损伤声带的情况下彻底切除了肉芽组织。呼吸功能得以恢复，无需进行诸如会厌切除术或声带切除术等与发声功能改变相关的其他治疗。未记录到术中及术后并发症，患者在手术后7天出院。
