Shimizu Nahoko, Tanaka Yugo, Kuroda Sanae, Nakamura Hayate, Matsumoto Gaku, Mitsui Suguru, Sakai Shuto, Minami Kazuhiro, Okamoto Takeshi, Doi Takefumi, Hokka Daisuke, Maniwa Yoshimasa
Division of Thoracic Surgery, Kobe University, Kobe, Japan.
Kyobu Geka. 2018 Nov;71(12):1018-1021.
Idiopathic subglottic stenosis (ISS) is defined as the narrowing of the upper airway without any known cause. A 40-year-old female was referred to our hospital with the complaint of exacerbation of dyspnea causing difficulty in going out. Chest computed tomography (CT) scan and bronchoscopy revealed subglottic tracheal stenosis with a luminal diameter of 5 mm at the narrowest part. Tracheal mucosa of the stenotic lesion was smooth, and the patient had no previous medical history. Subglottic tracheal resection of the stenotic lesion and reconstruction were performed. The postoperative course was good, and the symptom of dyspnea improved significantly. Recently, some reports have suggested conservative treatments such as laser and balloon dilation for ISS, but the recurrence rate after these treatments is still high. Surgery is recommended rather than conservative treatments for patients with less severe inflammation of tracheal mucosa and other comorbidities like present case.
特发性声门下狭窄（ISS）被定义为无任何已知病因的上呼吸道狭窄。一名40岁女性因呼吸困难加重导致外出困难而转诊至我院。胸部计算机断层扫描（CT）和支气管镜检查显示声门下气管狭窄，最窄处管腔直径为5毫米。狭窄病变的气管黏膜光滑，患者既往无病史。对狭窄病变进行了声门下气管切除及重建手术。术后病程顺利，呼吸困难症状明显改善。最近，一些报告提出了针对ISS的激光和球囊扩张等保守治疗方法，但这些治疗后的复发率仍然很高。对于气管黏膜炎症较轻且有其他合并症的患者，如本病例，建议采用手术而非保守治疗。
