Lahav Yonatan, Shoffel-Havakuk Hagit, Halperin Doron
Department of Otolaryngology - Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
Department of Otolaryngology - Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel.
J Voice. 2015 Sep;29(5):646.e1-646.e10. doi: 10.1016/j.jvoice.2014.10.012. Epub 2015 Mar 17.
To review the etiology and pathogenesis of acquired glottic stenosis, as well as the workup, patient preparation, interventional options, and their changing trends, as described in the literature since the 19th century until the present day.
Literature from the PubMed search engine and the authors' personal experience were used. The search included up to date studies and historical reports covering different aspects of glottic stenosis, such as basic science, pathogenesis, anesthesia, and surgical techniques.
At present, the most common etiology for acquired glottic stenosis is damage to the posterior commissure after intubation. Until less than a century ago, infectious diseases such as diphtheria and syphilis were the most prevalent etiologies. The common pathway of stenosis includes mucosal and cartilaginous ulcers, granulation formation, fibrosis, and tethering scars. Planning of surgical intervention must begin with the matching of expectations with the patient and considering voice versus airway functions. Preoperative tracheotomy should be considered for securing the airway. Anesthesia has to be carefully planned, and both the surgeon and the anesthesiologist have to be familiar with the options for tubeless jet ventilation. Surgical options include a variety of open and endoscopic resection and reconstruction procedures, which are reviewed in this article, followed by images and illustrations based on the authors' experience.
Acquired glottic stenosis compromises the breathing, voice production, and airway protection. Reconstructing the stenosed glottis is one of the major challenges facing laryngologists in this era. For this reason, the surgeon must be familiar with the variety of treatment options.
回顾自19世纪至今文献中所描述的后天性声门狭窄的病因、发病机制，以及检查方法、患者准备、干预选择及其变化趋势。
使用来自PubMed搜索引擎的文献以及作者的个人经验。检索包括涵盖声门狭窄不同方面的最新研究和历史报告，如基础科学、发病机制、麻醉和手术技术。
目前，后天性声门狭窄最常见的病因是插管后后联合受损。直到不到一个世纪前，白喉和梅毒等传染病还是最常见的病因。狭窄的常见途径包括黏膜和软骨溃疡、肉芽形成、纤维化和条索状瘢痕。手术干预的规划必须始于使患者的期望与实际情况相匹配，并考虑嗓音功能与气道功能。为确保气道安全，应考虑术前气管切开术。必须仔细规划麻醉，外科医生和麻醉医生都必须熟悉无管喷射通气的选择。手术选择包括多种开放和内镜下切除及重建手术，本文对此进行了综述，并附有基于作者经验的图像和插图。
后天性声门狭窄会损害呼吸、发声和气道保护功能。重建狭窄的声门是这个时代喉科医生面临的主要挑战之一。因此，外科医生必须熟悉各种治疗选择。
