Chau Steven M, Kim Christine M, Vahabzadeh-Hagh Andrew, Verma Sunil P, Chhetri Dinesh K
Department of Otolaryngology-Head and Neck Surgery, University Voice and Swallowing Center, University of California Irvine, Irvine, California.
Department of Head and Neck Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, U.S.A.
Laryngoscope. 2019 Jul;129(7):1647-1649. doi: 10.1002/lary.27688. Epub 2018 Dec 26.
OBJECTIVES/HYPOTHESIS: Unilateral ML is a commonly performed surgery for dysphonia secondary to glottic insufficiency. The safety of this procedure performed in the outpatient setting has not been extensively examined. The purpose of the study was to assess the safety of outpatient unilateral ML in adults and determine the incidence and timing of postoperative complications across two tertiary-care academic medical centers.
Retrospective chart review, METHODS: A review of patients undergoing unilateral ML at two tertiary-care academic centers from 2011 to 2017 was performed. Patients undergoing bilateral medialization laryngoplasty, revision surgery, or those undergoing additional laryngeal framework procedures including arytenoid adduction were excluded. Patient demographics, operative details, and perioperative and postoperative complications were recorded. Comparisons were made between those individuals who underwent inpatient versus outpatient ML.
One hundred three total procedures met inclusion criteria. Fifty-seven were performed as outpatient procedures, and 46 individuals were observed for at least 23 hours following surgery. Silastic or Gore-Tex implants were used in all but two surgeries. There were no postoperative complications in either setting, including hematoma, dyspnea, wound infections or seromas.
The incidence of adverse events during and immediately following unilateral ML is very low. Patients can be discharged safely the day of surgery without geographic restrictions.
4 Laryngoscope, 129:1647-1649, 2019.
目的/假设:单侧杓状软骨内移术(ML)是治疗声门闭合不全所致发音障碍的常用手术。在门诊进行该手术的安全性尚未得到广泛研究。本研究的目的是评估成人门诊单侧ML的安全性,并确定两个三级医疗学术中心术后并发症的发生率和发生时间。
回顾性病历审查。
对2011年至2017年在两个三级医疗学术中心接受单侧ML的患者进行回顾。排除接受双侧喉内移术、翻修手术或接受包括杓状软骨内收术在内的其他喉框架手术的患者。记录患者的人口统计学资料、手术细节以及围手术期和术后并发症。对接受住院和门诊ML的患者进行比较。
共有103例手术符合纳入标准。其中57例为门诊手术,46例患者术后至少观察23小时。除两例手术外,其余均使用硅橡胶或戈尔特斯(Gore-Tex)植入物。两种情况下均未出现术后并发症,包括血肿、呼吸困难、伤口感染或血清肿。
单侧ML术中及术后即刻不良事件的发生率非常低。患者术后当天可安全出院,不受地域限制。
4。《喉镜》,2019年,第129卷,第1647 - 1649页。