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柔性二氧化碳激光治疗声门下狭窄

Flexible CO2 Laser Treatment for Subglottic Stenosis.

作者信息

Cevizci Rasit, Dilci Alper, Can Ilknur Haberal, Kersin Burak, Bayazit Yildirim

机构信息

*Department of Otolaryngology, Istanbul Medipol University, Istanbul †Department of Otolaryngology, Yunus Emre State Hospital, Eskisehir, Turkey.

出版信息

J Craniofac Surg. 2017 Jun;28(4):983-984. doi: 10.1097/SCS.0000000000003549.

Abstract

OBJECTIVES

To assess the efficacy and safety of flexible fiber CO2 laser surgery for subglottic stenosis and to present retrospective experience of 14 patients treated with flexible fiber CO2 laser system. To determine the characteristics, management protocols, prognostic factors, and postoperative outcomes of the sample.

METHODS

Retrospective review of patients with subglottic stenosis undergoing flexible fiber CO2 laser surgery at the tertiary medical center. All demographic and clinical data were collected, radiologic and endoscopic evaluations were performed to assess the characteristics of stenosis. Myer-Cotton grading scale was used for classification of stenotic area.

RESULTS

All patients have subglottic stenosis due to intubation-related causes and inappropriate tracheostomy procedure. The duration of intubation period ranged from 15 days to 4 years; 11 patients have grade III stenosis according to Myer-Cotton system and there was cricoid involvement in 2 patients. The mean follow-up period was 5.2 months and postoperative decannulation was achieved in 10 patients (71.4%).

CONCLUSIONS

Subglottic stenosis is the difficult situation to manage minimal invasively. Flexible fiber CO2 laser surgery is safe and effective in the management of properly selected patients and can be used as a first option for patients.

摘要

目的

评估软性纤维二氧化碳激光手术治疗声门下狭窄的疗效和安全性,并介绍14例接受软性纤维二氧化碳激光系统治疗患者的回顾性经验。确定该样本的特征、管理方案、预后因素和术后结果。

方法

对在三级医疗中心接受软性纤维二氧化碳激光手术治疗的声门下狭窄患者进行回顾性研究。收集所有人口统计学和临床数据,进行影像学和内镜评估以评估狭窄特征。采用迈尔-科顿分级量表对狭窄区域进行分类。

结果

所有患者均因插管相关原因和不当气管切开术导致声门下狭窄。插管期持续时间为15天至4年;根据迈尔-科顿系统,11例患者为III级狭窄,2例患者环状软骨受累。平均随访期为5.2个月,10例患者(71.4%)术后拔管。

结论

声门下狭窄是微创治疗的难题。软性纤维二氧化碳激光手术在适当选择的患者管理中安全有效,可作为患者的首选治疗方法。

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