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儿童获得性声门下狭窄球囊扩张术的长期疗效

Long-term outcomes of balloon dilation for acquired subglottic stenosis in children.

作者信息

Filiz Aliye, Ulualp Seckin O

机构信息

Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center and Children's Medical Center, 5323 Harry Hines, Dallas, TX 75390-9035, USA.

出版信息

Case Rep Otolaryngol. 2014;2014:304593. doi: 10.1155/2014/304593. Epub 2014 Feb 19.

Abstract

Objectives. Balloon dilation laryngoplasty has been suggested as an alternative treatment to open surgical treatment of acquired subglottic stenosis in children. We describe long-term outcomes of balloon dilation for acquired subglottic stenosis in children. Methods. The medical charts of children who had balloon dilation for subglottic stenosis secondary to intubation were reviewed. Data included demographics, relevant history and physical examination, diagnostic workup, and management. Outcomes of balloon dilation were assessed based on improvement in preoperative symptoms, grading of stenosis, complications, and need for additional procedures. Results. Three children (2 male, 1 female, age range: 14 weeks-1 year) underwent balloon dilation for acquired subglottic stenosis. Patients presented with stridor and increased work of breathing. Duration of intubation ranged from 2 days to 3 weeks. Patients became symptomatic 5 days to 6 weeks after extubation. Grade of subglottic stenosis was II in 2 patients and III in one. Subglottic stenosis patients had 2-3 dilations within 2-10 weeks. All patients were asymptomatic during 14-21-month follow-up. Conclusions. Serial balloon dilation was safe and successful method to manage acquired subglottic stenosis in this group of children. No recurrence was noted in a follow-up more than a year after resolution of symptoms.

摘要

目的。球囊扩张喉成形术已被提议作为儿童后天性声门下狭窄开放手术治疗的替代疗法。我们描述了儿童后天性声门下狭窄球囊扩张的长期结果。方法。回顾了因插管继发声门下狭窄而接受球囊扩张的儿童的病历。数据包括人口统计学、相关病史和体格检查、诊断检查及治疗情况。基于术前症状的改善、狭窄分级、并发症以及是否需要额外手术来评估球囊扩张的结果。结果。三名儿童(2名男性,1名女性,年龄范围:14周 - 1岁)因后天性声门下狭窄接受了球囊扩张。患者表现为喘鸣和呼吸费力增加。插管时间从2天到3周不等。患者在拔管后5天至6周出现症状。2例患者声门下狭窄为II级,1例为III级。声门下狭窄患者在2 - 10周内进行了2 - 3次扩张。在14 - 21个月的随访期间,所有患者均无症状。结论。对于这组儿童,连续球囊扩张是治疗后天性声门下狭窄安全且成功的方法。症状缓解一年多后的随访中未发现复发情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/148e/3965922/c9c2ebbd0f0c/CRIOT2014-304593.001.jpg

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