Yılmaz Taner, Süslü Nilda, Günaydın Rıza Önder, Kuşçu Oğuz, Sözen Tevfik, Atay Gamze, Bajin Münir Demir
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Department of Otolaryngology-Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
J Voice. 2016 Nov;30(6):751-754. doi: 10.1016/j.jvoice.2015.08.001. Epub 2015 Aug 29.
Laryngeal stenosis is the most challenging disorder for the laryngologist to treat. Microtrapdoor flap technique was described in 1980s; however, it has not been popular since then. The reason may be the difficulty of the technique. In this study, we will report our experience with microtrapdoor flap technique to treat glottic stenosis of 34 patients.
Retrospective case series of a tertiary referral center.
Twelve male and 22 female patients make up our study group. All patients, but one, had pure glottic stenosis. The other patient had combined supraglottic and glottic stenosis. Unilateral or bilateral microtrapdoor technique was applied to all patients. The patients are required to have at least 1 year postoperative follow-up.
The etiology of glottic stenosis includes 19 cases due to failed surgery for bilateral vocal fold paralysis; seven cases due to microlaryngoscopy (three laryngeal papilloma, one leukoplakia excision, one glottic cancer excision, one foreign body extraction, one biopsy from interarytenoid region); four cases due to prolonged intubation; one case due to laryngeal fracture, one case due to vertical laryngectomy, one case due to smoke inhalation (burn), and one case congenital or idiopathic. Seventeen patients had tracheotomy. All seventeen of them were decannulated 2 months postoperatively. Thirty-three patients (97%) were dyspnea free on exertion 1 year postoperatively. One patient developed restenosis and dyspnea 1 year after treatment; she needs retreatment.
Microtrapdoor flap technique is a successful surgical option for treatment of short-segment laryngeal stenosis.
喉狭窄是喉科医生治疗中最具挑战性的疾病。微型活板门瓣技术于20世纪80年代被描述；然而，从那时起它就没有流行起来。原因可能是该技术难度较大。在本研究中，我们将报告我们使用微型活板门瓣技术治疗34例声门狭窄患者的经验。
三级转诊中心的回顾性病例系列研究。
我们的研究组由12名男性和22名女性患者组成。除1例患者外，所有患者均为单纯声门狭窄。另1例患者合并声门上和声门狭窄。所有患者均采用单侧或双侧微型活板门技术。要求患者术后至少随访1年。
声门狭窄的病因包括：双侧声带麻痹手术失败19例；显微喉镜检查后7例（3例喉乳头状瘤、1例白斑切除术、1例声门癌切除术、1例异物取出术、1例杓间区活检）；长时间插管4例；喉骨折1例、垂直喉切除术1例、吸入烟雾（烧伤）1例、先天性或特发性1例。17例患者行气管切开术。他们术后2个月均拔除气管套管。33例患者（97%）术后1年运动时无呼吸困难。1例患者治疗后1年出现再狭窄和呼吸困难，需要再次治疗。
微型活板门瓣技术是治疗短节段喉狭窄的一种成功的手术选择。
