Ruberto M, Alicandri-Ciufelli M, Grammatica A, Marchioni D, Bergamini G, Presutti L
Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy;
Otolaryngology Department, National Institute of Cancer "Regina Elena" IRCCS, Rome, Italy.
Acta Otorhinolaryngol Ital. 2014 Aug;34(4):247-52.
To analyse the complications related to pexy, the main clinical manifestations that may raise suspicions of a pexy line rupture/detachment, the most suitable diagnostic technique and the optimum treatment to resolve this complication. This is a retrospective chart review in tertiary university referral centre. Medical charts of patients with oncological laryngeal pathologies admitted to the Otolaryngology Department of the University Hospital of Modena between May 2003 and March 2012 were analysed. Ten patients with rupture of the pexy were identified and included in the present study. The clinical manifestations were dysphagia, alteration of sensitivity of hypopharyngeallaryngeal structures, fever, infection and diastasis of surgical wounds, bleeding, dysphonia and aspiration pneumonia. Rupture of the pexy was diagnosed through endoscopic evaluations, radiological techniques or directly in the operating room during revision surgery of the earlier operation. Surgical treatments, coupled with effective swallowing rehabilitation, allowed progressive functional recovery. Patients were hospitalised until recovery of laryngeal functions was complete. In conclusion, pexy line rupture is one of the complications in the post-operative period of partial laryngectomies. Certain clinical manifestations may indicate this complication, helping the surgeon to establish an early diagnosis and administer prompt treatment.
分析与固定术相关的并发症、可能提示固定线破裂/脱离的主要临床表现、最合适的诊断技术以及解决该并发症的最佳治疗方法。这是一项在三级大学转诊中心进行的回顾性病历审查。分析了2003年5月至2012年3月期间摩德纳大学医院耳鼻喉科收治的患有喉部肿瘤性疾病患者的病历。确定了10例固定线破裂患者并纳入本研究。临床表现为吞咽困难、下咽-喉部结构感觉改变、发热、感染、手术伤口分离、出血、声音嘶哑和吸入性肺炎。通过内镜评估、放射学技术或在早期手术的翻修手术中直接在手术室诊断出固定线破裂。手术治疗结合有效的吞咽康复，使功能逐渐恢复。患者住院直至喉部功能完全恢复。总之，固定线破裂是部分喉切除术后的并发症之一。某些临床表现可能提示该并发症，有助于外科医生早期诊断并及时治疗。
