Beswick Daniel M, Collins Jeremy, Nekhendzy Vladimir, Damrose Edward J
Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California, U.S.A.
Laryngoscope. 2015 Apr;125(4):946-9. doi: 10.1002/lary.24967. Epub 2014 Oct 24.
This case describes the development of laryngeal chondronecrosis after use of the laryngeal mask airway (LMA). A 69-year-old male with prior laryngeal irradiation underwent total knee replacement with general anesthesia via LMA. Postoperatively, he developed laryngeal chondronecrosis, bilateral vocal fold immobility, and aspiration, necessitating tracheostomy and gastrostomy placement. He improved with hyperbaric oxygen therapy, intravenous antibiotics, and endoscopic repair of a residual fistula. Vocal fold motion returned and he was decannulated. Chondronecrosis of the larynx may occur with the use of the LMA, and caution should be used in patients with a history of prior laryngeal irradiation.
本病例描述了使用喉罩气道（LMA）后发生喉软骨坏死的情况。一名69岁男性，既往有喉部放疗史，通过LMA全身麻醉下行全膝关节置换术。术后，他出现了喉软骨坏死、双侧声带麻痹和误吸，需要行气管造口术和胃造口术。他通过高压氧治疗、静脉使用抗生素以及对残余瘘管进行内镜修复后病情好转。声带运动恢复，他拔除了气管套管。使用LMA可能会发生喉软骨坏死，对于有喉部放疗史的患者应谨慎使用。
