Department of Otorhinolaryngology, Mansoura University, Egypt.
Department of Otorhinolaryngology, Mansoura University, Egypt.
Auris Nasus Larynx. 2020 Aug;47(4):616-623. doi: 10.1016/j.anl.2020.01.004. Epub 2020 Feb 5.
This study was conducted to review our experience in Otorhinolaryngology Department, Mansoura University Hospitals, Egypt, in the last 2 years in the management of high-risk patients who underwent cricotracheal resection due to different pathologies.
This case series included nine patients with severe, grade III or IV subglottic / cervical tracheal stenosis. These patients were considered high risk patients due to unusual pathology / etiology of stenosis or associated surgical field morbidity. Four patients had recurrent stenosis after previous unsuccessful cricotracheal resection, three patients had subglottic stenosis due to external neck trauma which compromised the surgical field. One patient had upper tracheal neoplasm, and in 1 patient there was upper tracheal stenosis associated with tracheo-esophageal fistula.
Successful decannulation was achieved in all patients (n = 9) without any reported major intraoperative or postoperative compilations.
Cases of subglottic / upper tracheal stenosis due to uncommon pathologies like neoplastic lesions, external neck trauma compromising the surgical field and revision cricotracheal resection, can be successfully managed by cricotracheal resection. However, a highly skilled team, well familiar with these surgeries, is mandatory to achieve an optimum outcome.
本研究回顾了埃及曼苏拉大学医院耳鼻喉科在过去 2 年中对因不同病理原因行环状软骨气管切除术的高危患者的治疗经验。
本病例系列包括 9 例严重、III 级或 IV 级会厌下/颈气管狭窄患者。这些患者因狭窄的异常病理/病因或相关手术部位并发症而被认为是高危患者。4 例患者在前次不成功的环状软骨气管切除术后出现复发性狭窄，3 例患者因颈部外部创伤导致会厌下狭窄，手术部位受损。1 例患者有上气管肿瘤，1 例患者有与气管食管瘘相关的上气管狭窄。
所有患者（n=9）均成功拔管，无任何术中或术后重大并发症报告。
由肿瘤病变、颈部外部创伤影响手术部位和环状软骨气管切除术翻修等不常见病因引起的会厌下/上气管狭窄病例可通过环状软骨气管切除术成功治疗。然而，需要一支高度熟练的团队，对这些手术非常熟悉，才能获得最佳结果。
