Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.
Department of Anesthesia and Perioperative Medicine, Western University, London, Ontario, Canada.
Laryngoscope. 2020 Apr;130(4):880-885. doi: 10.1002/lary.28096. Epub 2019 May 30.
OBJECTIVES/HYPOTHESIS: Postoperative uvular necrosis is rare, but can be distressing to the patient when it unexpectedly occurs. Little has been published regarding its predisposing factors and pathophysiology. The purpose of this comprehensive review was to compile cases of postoperative uvular necrosis and identify risk factors and potential causes for this complication.
Retrospective case series.
The study was performed at an academic tertiary care referral center. Clinical records from four patients treated for postoperative uvular necrosis from 2008 to 2018 were reviewed. A comprehensive literature review was also performed. The MEDLINE, Embase, and Scopus databases were searched, as well as the grey literature. All case reports and literature reviews in the English literature from 1978 to 2018 were systematically identified for review.
Four cases of postoperative uvular necrosis diagnosed clinically at our institution were included. The comprehensive literature review identified 26 reports and seven case series, totaling 53 cases of this complication. Use of suction was reported in 19 cases, and six cases reported no use of suction. Ninety-four percent of cases were treated conservatively, whereas 6% underwent excision. Ninety-one percent resolved within 14 days.
Impingement with various devices and vascular trauma from suction each likely play a role in postoperative uvular necrosis. Male oropharyngeal anatomy may be a risk factor, but neither the type of instrumentation nor the type of procedure seem to predict this complication. Proper positioning of the patient and instruments and minimizing suction force help prevent uvular injury.
NA Laryngoscope, 130:880-885, 2020.
目的/假设：术后悬雍垂坏死很少见，但当它意外发生时，会给患者带来痛苦。关于其诱发因素和病理生理学的研究甚少。本综述的目的是收集术后悬雍垂坏死的病例，并确定该并发症的危险因素和潜在原因。
回顾性病例系列。
该研究在一家学术性三级护理转诊中心进行。对 2008 年至 2018 年期间因术后悬雍垂坏死接受治疗的 4 例患者的临床记录进行了回顾。还进行了全面的文献回顾。在 MEDLINE、Embase 和 Scopus 数据库以及灰色文献中进行了搜索。系统地检索了 1978 年至 2018 年英语文献中的所有病例报告和文献综述。
本机构共确诊 4 例术后悬雍垂坏死病例。全面的文献回顾确定了 26 份报告和 7 个病例系列，共 53 例该并发症。19 例报告使用了吸引器，6 例报告未使用吸引器。94%的病例接受了保守治疗，6%的病例进行了切除。91%的病例在 14 天内痊愈。
各种器械的撞击和吸引引起的血管创伤可能都在术后悬雍垂坏死中起作用。男性口咽解剖结构可能是一个危险因素，但器械类型和手术类型似乎都不能预测这种并发症。正确放置患者和器械，并尽量减少吸力有助于防止悬雍垂损伤。
NA 喉镜，130：880-885，2020。
