Carr S, Dritsoula A, Thevasagayam R
Department of Otolaryngology,Sheffield Children's Hospital,UK.
J Laryngol Otol. 2018 Aug;132(8):753-756. doi: 10.1017/S0022215118001226. Epub 2018 Jul 16.
Anterior cricoid split is performed for grade 2 and 3 subglottic stenosis, which can be a cause of extubation failure. It can be performed endoscopically or as an open procedure. This paper describes a case series of endoscopic cricoid split procedures performed using a bespoke sickle knife.
Nine patients (six pre-term infants) underwent endoscopic cricoid split in a tertiary referral paediatric unit between August 2012 and March 2015.
Six patients (67 per cent; four pre-term and two term infants) were on oxygen pre-operatively. Mean age at operation was 30 weeks (range, 11-104 weeks). Mean number of days' intubation was 5.6 days (range, 4-9 days). All five patients intubated pre-operatively were extubated. Seven patients required repeat dilatations. One patient required tracheostomy.
The extubation rates for endoscopic cricoid split are comparable to the open procedure. It is a safe and efficient method for managing subglottic stenosis, whether acquired or congenital. The main advantage is the shorter operative time, in addition to the avoidance of an external scar and drain.
环状软骨前部劈开术用于治疗2级和3级声门下狭窄，这可能是拔管失败的一个原因。该手术可通过内镜进行，也可作为开放手术。本文描述了一系列使用定制镰刀状刀进行的内镜环状软骨劈开术病例。
2012年8月至2015年3月期间，9例患者（6例早产儿）在一家三级转诊儿科单位接受了内镜环状软骨劈开术。
6例患者（67%；4例早产儿和2例足月儿）术前吸氧。手术平均年龄为30周（范围11 - 104周）。平均插管天数为5.6天（范围4 - 9天）。所有术前插管的5例患者均成功拔管。7例患者需要重复扩张。1例患者需要气管造口术。
内镜环状软骨劈开术的拔管率与开放手术相当。它是治疗声门下狭窄（无论是后天性还是先天性）的一种安全有效的方法。主要优点是手术时间较短，此外还避免了外部瘢痕和引流。
