Wu Z B, Li L, Pan H G, Liang Z J, Xian Z X, Zhang D L, Teng Y S, Ma X Y
Department of Otorhinolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong 518026, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Sep 7;52(9):681-685. doi: 10.3760/cma.j.issn.1673-0860.2017.09.009.
To investigate the diagnosis and management of laryngeal cleft. The clinical data of 13 cases of laryngeal cleft treated between 2007 and 2015 was analyzed retrospectively. The children with laryngeal cleft were classified according to the classification of Benjamin-Inglis, as type Ⅰ(11 cases), typeⅡ(1 case) and type Ⅲ(1 case). All patients were confirmed by microlaryngobronchoscopy under general anaesthetic. Eleven typeⅠ and 1 type Ⅱ clefts were managed conservatively, with which all type Ⅰ patients were successfully managed, while the type Ⅱ patient was resolved by surgical endoscopy. The type Ⅲ patient was treated by open repair but the results was poor. Patients who suffered with choking on feeding or recurrent aspiration pneumonia, especially coexisted with other congenital malformation, needed detailed evaluation for laryngeal cleft, although which was a rare congenital abnormality. Electronic laryngoscope could be the first step to screen the cleft, while microlaryngobronchoscopy is the gold standard for diagnosis of laryngeal cleft. The majority of children with lower type clefts can be managed conservatively. Surgical endoscopy has high success rate when strictly following the indication. Type Ⅲ and Ⅳ clefts have high mortality for usually combining with severe complications and abnormalities.
探讨喉裂的诊断与治疗。回顾性分析2007年至2015年间收治的13例喉裂患儿的临床资料。喉裂患儿按Benjamin-Inglis分类法分为Ⅰ型（11例）、Ⅱ型（1例）和Ⅲ型（1例）。所有患者均在全身麻醉下行显微喉镜支气管镜检查确诊。11例Ⅰ型和1例Ⅱ型喉裂采用保守治疗，其中Ⅰ型患者均成功治愈，Ⅱ型患者经手术内镜治疗后好转。Ⅲ型患者行开放性修复，但效果不佳。对于有喂养呛咳或反复吸入性肺炎，尤其是合并其他先天性畸形的患者，尽管喉裂是一种罕见的先天性异常，仍需对其进行详细的喉裂评估。电子喉镜可作为筛查喉裂的第一步，而显微喉镜支气管镜检查是诊断喉裂的金标准。大多数低位喉裂患儿可采用保守治疗。严格掌握适应证时，手术内镜治疗成功率较高。Ⅲ型和Ⅳ型喉裂通常合并严重并发症和畸形，死亡率较高。
