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改良式 Minerva 颈胸椎矫形器在环甲切除术后的应用。

Modified Minerva Cervical Thoracic Orthosis for Postoperative Management of Cricotracheal Resection.

机构信息

Department of Medicine, 1259University of Michigan Health System, Ann Arbor, MI, USA.

Department of Pediatrics Otolaryngology Head and Neck Surgery, 21634C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA.

出版信息

Ear Nose Throat J. 2021 Feb;100(2):NP105-NP108. doi: 10.1177/0145561319859348. Epub 2019 Jul 11.

Abstract

The worst complication of cricotracheal resection (CTR) is anastomotic dehiscence, and to limit it, postoperative management at Michigan Medicine included the use of a modified Minerva cervical-thoracic orthosis (MMCTO). To date, there has been no analysis of the risks and benefits of the brace's use following CTR. We analyze this with our retrospective study. A search with the keywords "cricotracheal resection" and "laryngotracheal reconstruction" was performed in the Electronic Medical Record Search Engine to identify patients retrospectively. The Statistical Package for Social Sciences was used for analysis; test, χ, and Fisher exact tests were used to analyze data. Fifteen males and 13 females with a median age of 4 years were identified, and almost 2/3 had a supra- and/or infrahyoid release performed. Postoperatively, 12 had a Grillo stitch and an MMCTO for a mean of 7 days. Most had no complications, but the most common complications were agitation due to brace discomfort and skin irritation. The worst complication was stroke. Our MMCTO's design allowed for better head and neck control with relative comfortability, and most patients had no complications with its short-term use. Our modification may be useful adjunct in the postoperative management.

摘要

环状软骨气管切开术(CTR)最严重的并发症是吻合口裂开,为了限制这种情况的发生,密歇根大学医学中心的术后管理包括使用改良的 Minerva 颈胸矫形器(MMCTO)。迄今为止,还没有对 CTR 后使用该支具的风险和益处进行分析。我们通过回顾性研究对此进行了分析。在电子病历搜索引擎中使用“环状软骨气管切开术”和“喉气管重建”等关键词进行了检索,以回顾性地识别患者。使用社会科学统计软件包进行分析;使用 t 检验、卡方检验和 Fisher 确切检验来分析数据。共确定了 15 名男性和 13 名女性患者,中位年龄为 4 岁,近 2/3 的患者行颏舌骨肌松解术和/或甲状舌骨肌松解术。术后 12 例行 Grillo 缝线和 MMCTO 固定,平均时间为 7 天。大多数患者没有并发症,但最常见的并发症是因支具不适和皮肤刺激引起的躁动。最严重的并发症是中风。我们的 MMCTO 设计允许更好地控制头部和颈部,相对舒适,大多数患者在短期使用时没有并发症。我们的改良可能是术后管理的有用辅助手段。

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