Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, U.S.A.
Laryngoscope. 2020 May;130(5):E346-E348. doi: 10.1002/lary.28199. Epub 2019 Aug 2.
Silicone stents are commonly employed to treat subglottic stenosis. A frequent complication is the tendency of stents to migrate. As such, various techniques to secure stents have been developed over the years, none of which have gained large popularity. We present a novel, low-cost, and easy-to-perform technique herein.
To describe a novel surgical technique to secure silicone stents and prevent migration for management of subglottic stenosis.
After standard excision and dilation of stenotic portions in the subglottic or trachea. A silicone stent is introduced in a standard fashion. To secure the stent, an 18-G needle loaded with braided suture is inserted through skin, trachea, and stent. Endoscopic visualization then permits the surgeon to grasp the suture with forceps. A separate transcutaneous puncture site is performed with an 18-G needle attached to a 10-cc syringe (plunger removed) and blue tip suction within the empty syringe, creating an airtight suctioning tool. The grasped suture is gently introduced into the eye of the needle and quickly travels into the 10-cc syringe with suction assist, leaving both extracorporeal ends of the suture to tie.
This stitch has been employed on seven occasions on four patients. There have been no episodes of stent migration. A laboratory model found the 18-G needle and braided 3-0 suture performed optimally.
We present a novel surgical technique to secure silicone stents in management subglottic or tracheal stenosis.
Level 4 Laryngoscope, 130:E346-E348, 2020.
硅胶支架常用于治疗声门下狭窄。常见的并发症是支架迁移。因此，多年来开发了各种固定支架的技术，但都没有得到广泛应用。我们在此介绍一种新颖、低成本且易于操作的技术。
描述一种新颖的手术技术，以固定硅胶支架并防止其迁移，从而治疗声门下狭窄。
在声门下或气管的狭窄部位进行标准切除和扩张后，以标准方式引入硅胶支架。为了固定支架，将带有编织缝线的 18-G 针穿过皮肤、气管和支架插入。然后通过内窥镜可视化，用钳子抓住缝线。通过用附有 10-cc 注射器（拔出柱塞）的 18-G 针进行单独的经皮穿刺点，并在空注射器内使用蓝色尖端吸引器，创建一个密封的抽吸工具。将抓住的缝线轻轻引入针的眼中，并在吸力的帮助下迅速进入 10-cc 注射器，留下缝线的两个体外端进行系紧。
该缝线已在四名患者的七次手术中使用，没有支架迁移的情况发生。实验室模型发现 18-G 针和编织 3-0 缝线的性能最佳。
我们提出了一种新颖的手术技术，用于固定硅胶支架以治疗声门下或气管狭窄。
喉镜，130：E346-E348，2020 年。
