DuBois J J, Pokorny W J, Harberg F J, Smith R J
Department of Surgery, Baylor College of Medicine, Houston, TX 77030.
J Pediatr Surg. 1990 Aug;25(8):855-60. doi: 10.1016/0022-3468(90)90191-b.
Laryngeal and laryngotracheoesophageal clefts (L-LTEC) are uncommon anomalies in neonates that cause significant morbidity secondary to aspiration, pneumonia, and respiratory distress. Other anomalies of development, such as esophageal atresia and tracheoesophageal fistula (EA-TEF), are observed in 20% of patients with L-LTEC and often confuse the radiographic and clinical picture. Repair of L-LTEC depends on the length and location of the cleft, associated anomalies, and concurrent systemic illness. For type I L-LTEC, endoscopic repair occasionally is possible with microsurgical instrumentation. With types II to IV L-LTEC, an open approach must be used. Tracheotomy is a universal requirement, often for extended periods of time. Reported here is our experience with four cases of L-LTEC managed over the past 7 years at Texas Children's Hospital.
喉裂及喉气管食管裂（L-LTEC）在新生儿中是罕见的畸形，可因误吸、肺炎和呼吸窘迫导致严重发病。20%的L-LTEC患者还存在其他发育畸形，如食管闭锁和气管食管瘘（EA-TEF），这常使影像学和临床表现变得复杂。L-LTEC的修复取决于裂口的长度和位置、相关畸形以及并存的全身性疾病。对于I型L-LTEC，偶尔可使用显微手术器械进行内镜修复。对于II至IV型L-LTEC，则必须采用开放手术方法。气管切开术是普遍需要的，而且往往需要很长时间。本文报告了我们在德克萨斯儿童医院过去7年中处理4例L-LTEC的经验。
