激光辅助会厌前间隙解剖会影响内镜下声门成形术后的功能结果吗？
Could laser-assisted dissection of the pre-epiglottic space affect functional outcome after ESL?
作者信息
Bertolin Andy, Lionello Marco, Russo Simone, Rizzotto Giuseppe, Lucioni Marco
机构信息
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Treviso, Italy.
Otolaryngology Section, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy.
出版信息
Laryngoscope. 2018 Jun;128(6):1371-1378. doi: 10.1002/lary.26961. Epub 2017 Oct 27.
OBJECTIVES
To evaluate the effect of preepiglottic space (PES) dissection in the endoscopic supraglottic laryngectomy (ESL).
STUDY DESIGN
A retrospective cohort study.
METHODS
We retrospectively compared 15 patients who underwent ESL with 15 patients matched for clinical stage who underwent open partial horizontal laryngectomy (OPHL). The functional outcomes were assessed in terms of hospital stay; need for nasal feeding tube (NFT) and tracheostomy, as well as duration of their use; postoperative complications; aspiration pneumonia rates; voice quality; and dysphagia.
RESULTS
Among the ESL cases, combined dissection of the epiglottis and PES (type III) had a negative impact on functional outcomes. ESL patients experienced shorter hospital stays, as well as shorter use of NFT and tracheostomy, than patients who had OPHL.
CONCLUSION
Combined dissection of the epiglottis and PES (ESL type III) negatively affected functional outcome in patients undergoing ESL, a procedure generally related to significantly better functional outcomes than OPHL type I.
LEVEL OF EVIDENCE
- Laryngoscope, 128:1371-1378, 2018.
目的
评估会厌前间隙（PES）清扫在支撑喉镜下声门上喉切除术（ESL）中的作用。
研究设计
一项回顾性队列研究。
方法
我们回顾性比较了15例行ESL的患者与15例匹配临床分期的行开放性部分水平喉切除术（OPHL）的患者。从住院时间、鼻饲管（NFT）及气管切开的需求、使用时间、术后并发症、吸入性肺炎发生率、嗓音质量和吞咽困难等方面评估功能结局。
结果
在ESL病例中，会厌与PES联合清扫（III型）对功能结局有负面影响。ESL患者的住院时间、NFT及气管切开的使用时间均短于OPHL患者。
结论
会厌与PES联合清扫（ESL III型）对接受ESL的患者功能结局有负面影响，ESL通常比OPHL I型具有更好的功能结局。
证据等级
4。《喉镜》，2018年，第128卷，第1371 - 1378页。
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