Ojha S, Setlur J, Bunting G, Hartnick C J
Royal National Throat,Nose and Ear Hospital,London,UK.
Department of Otology and Laryngology,Harvard Medical School,Boston,Massachusetts,USA.
J Laryngol Otol. 2015 Aug;129(8):820-4. doi: 10.1017/S0022215115001553. Epub 2015 Jun 17.
To suggest a phonosurgical management strategy that can be used for children who have previously undergone laryngotracheal reconstruction.
This cases series describes three children who presented with complex, multi-level airway stenosis and marked dysphonia. Phonosurgical intervention involved endoscopic and open approaches, and was combined with voice therapy. A phonosurgical reconstruction management algorithm is suggested for evaluating and treating these complex conditions.
Pre-operative assessment is critical, and should involve voice analysis and glottal anatomy assessment using office laryngoscopy and stroboscopy. The risks must be weighed up against the benefit of vocal improvement. Surgical intervention should involve combined endoscopic and open approaches.
Voice restoration after paediatric airway reconstruction is a complex challenge. Surgical intervention should be conducted in a step-by-step manner to reduce the risk of worsening dysphonia and airway compromise. The risks and benefits must be carefully explored and discussed.
提出一种可用于曾接受喉气管重建术的儿童的嗓音外科治疗策略。
本病例系列描述了三名患有复杂的多级气道狭窄和明显发音障碍的儿童。嗓音外科干预包括内镜和开放手术方法，并结合了嗓音治疗。提出了一种嗓音外科重建治疗算法，用于评估和治疗这些复杂病症。
术前评估至关重要，应包括使用门诊喉镜和频闪喉镜进行嗓音分析和声门解剖评估。必须权衡风险与嗓音改善的益处。手术干预应包括内镜和开放手术方法相结合。
小儿气道重建后的嗓音恢复是一项复杂的挑战。手术干预应分步进行，以降低发音障碍恶化和气道受损的风险。必须仔细探讨和讨论风险与益处。
