Gnagi Sharon H, White David R
Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery Medical University of South Carolina, Charleston, South Carolina, USA.
Curr Opin Otolaryngol Head Neck Surg. 2016 Dec;24(6):516-521. doi: 10.1097/MOO.0000000000000310.
To discuss current modalities of endoscopic airway management beyond balloon dilation therapy.
Advances continue to be made through technology and bioengineering with exciting potential in the pediatric airway. Smaller robots and instrumentation allow increased endoscopic surgical success. Biodegradable stents and bioengineered grafts are on the horizon for use in airway surgery. Dysphonia following airway reconstruction is of increasing recognition with new endoscopic treatments being performed. Supraglottoplasty is further recognized as a treatment for obstructive sleep apnea for laryngomalacia diagnosed on sleep endoscopy. Interarytenoid injection may be beneficial in the normal larynx for aspiration and dysphagia as well as diagnosing and treating type I laryngeal clefts.
Endoscopic airway surgery continues to be a popular and effective method of treating the pediatric airway. Technological advances such as in robotics may have an increasing role in the future of endoscopic airway surgery in children. Bioengineered airway adjuncts including biodegradable airway stents look to be promising in the future treatment of airway stenosis.
探讨除球囊扩张治疗之外的当前内镜气道管理方式。
通过技术和生物工程不断取得进展，在儿科气道方面具有令人兴奋的潜力。更小的机器人和器械提高了内镜手术的成功率。可生物降解支架和生物工程移植物即将用于气道手术。气道重建后出现的发音障碍越来越受到重视，正在开展新的内镜治疗。声门上成形术进一步被认可为治疗睡眠内镜诊断为喉软化症的阻塞性睡眠呼吸暂停的一种方法。杓间注射对于正常喉部的误吸、吞咽困难以及诊断和治疗I型喉裂可能有益。
内镜气道手术仍然是治疗儿科气道的一种常用且有效的方法。诸如机器人技术等技术进步可能在未来儿童内镜气道手术中发挥越来越重要的作用。包括可生物降解气道支架在内的生物工程气道辅助装置在未来气道狭窄治疗中看起来很有前景。
