Marston Alexander P, White David R
Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, MUSC Children's Hospital, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA.
Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, MUSC Children's Hospital, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA.
Clin Perinatol. 2018 Dec;45(4):787-804. doi: 10.1016/j.clp.2018.07.013. Epub 2018 Aug 27.
The subglottis is a narrow region of the pediatric airway that is exquisitely susceptible to the development of airway stenosis. The incidence of acquired subglottic stenosis in the setting of prolonged intubation has significantly decreased because of improved endotracheal tube management protocols. Advances in otolaryngology interventions, such as balloon dilation and endoscopic cricoid split techniques, may allow the avoidance of tracheostomy in patients with mild to moderate subglottic stenosis. However, patients with severe subglottic stenosis are often tracheostomy dependent. Open surgical techniques to treat severe disease, such as laryngotracheal reconstruction and cricotracheal resection, offer high rates of tracheostomy decannulation.
声门下区是小儿气道的一个狭窄区域,极易发生气道狭窄。由于气管内导管管理方案的改进,长期插管情况下获得性声门下狭窄的发生率已显著降低。耳鼻喉科干预技术的进步,如球囊扩张和内镜环状软骨劈开技术,可能使轻至中度声门下狭窄患者避免行气管切开术。然而,重度声门下狭窄患者往往依赖气管切开术。治疗严重疾病的开放性手术技术,如喉气管重建和环状气管切除术,气管切开拔管率很高。