Monnier Philippe
Otolaryngology, Head and Neck Surgery Department, University Hospital CHUV, Rue du Bugnon 46, Lausanne CH 1011, Switzerland.
Thorac Surg Clin. 2018 May;28(2):177-187. doi: 10.1016/j.thorsurg.2018.01.012.
The management of pediatric laryngotracheal stenosis remains a challenging problem for the surgeon. The complexity of the various preoperative situations implies that no single treatment modality can solve the problem. This article focuses on the yield of partial cricotracheal resection and extended cricotracheal resection for the most severe grades of stenosis. Overall decannulation rates of 95% and 100% can be expected for isolated subglottic stenosis in patients with and without comorbidities but only 68% and 90% for patients with glotto-subglottic stenosis, respectively. Predictors of less favorable outcomes are severity of the stenosis, glottic involvement, and presence of comorbidities.
对于外科医生而言,小儿喉气管狭窄的治疗仍然是一个具有挑战性的问题。各种术前情况的复杂性意味着没有单一的治疗方式能够解决这个问题。本文重点关注部分环状气管切除术和扩大环状气管切除术对最严重程度狭窄的治疗效果。对于孤立性声门下狭窄且无合并症和有合并症的患者,总体拔管率分别可达95%和100%,但对于声门-声门下狭窄的患者,拔管率分别仅为68%和90%。预后较差的预测因素包括狭窄的严重程度、声门受累情况以及合并症的存在。