Gosavi Kundan, Dey Paulomi, Swami Sachin, Salunke Akshay
Department of Anesthesiology, Grant Government Medical College, Sir J. J. Hospital, Mumbai, Maharashtra, India.
Saudi J Anaesth. 2017 Oct-Dec;11(4):486-489. doi: 10.4103/sja.SJA_236_17.
Congenital laryngeal web is a rare anomaly with incidence of 1 in 10,000 births. Its clinical presentation may range from an asymptomatic patient or mild hoarseness of voice to severe respiratory stridor. The primary goals of surgical intervention for congenital laryngeal web are to establish a patent airway and to achieve a good voice quality. As recurrence rate after plain excision of laryngeal web is very high, its removal may be coupled by placement of a silastic keel in between vocal cords. Endolaryngeal placement of a keel is definitely less invasive than laryngofissure, but little is known about its anesthesia management. Frequent ventilatory adjustment and endotracheal tube (ETT) manipulations are needed along with vigilant monitoring. Risk of perforation or accidental dislodgment of the ETT and laryngeal edema are other concerns in management. We report a case.
先天性喉蹼是一种罕见的异常情况，发病率为万分之一。其临床表现范围从无症状患者或轻度声音嘶哑到严重的呼吸性喘鸣。先天性喉蹼手术干预的主要目标是建立通畅的气道并获得良好的嗓音质量。由于单纯切除喉蹼后的复发率非常高，切除喉蹼时可能需要在声带之间放置硅橡胶支架。在喉内放置支架肯定比喉裂开术侵入性小，但对其麻醉管理了解甚少。管理过程中需要频繁进行通气调整和气管内导管（ETT）操作，并进行密切监测。ETT穿孔或意外移位以及喉水肿的风险是管理中的其他关注点。我们报告一例病例。
