Makihara Seiichiro, Kariya Shin, Naito Tomoyuki, Uraguchi Kensuke, Matsumoto Junya, Noda Yohei, Okano Mitsuhiro, Nishizaki Kazunori
Department of Otolaryngology-Head & Neck Surgery, Kagawa Rosai Hospital, Kagawa, Japan.
Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
SAGE Open Med Case Rep. 2020 Apr 2;8:2050313X20915415. doi: 10.1177/2050313X20915415. eCollection 2020.
Perforation of the larynx is very rare but may result in severe airway complications that include pneumothorax, pneumonia, mediastinitis, and retropharyngeal abscess. If conservative treatment fails, aggressive treatments including reconstructive surgery with pedicle flap are considered. Negative pressure wound therapy has been used for large skin defects, necrotizing fasciitis, pharyngocutaneous fistula, stoma dehiscence, osteoradionecrosis of the mandible, chyle fistula, flap failure, and lymphangioma in the field of head and neck surgery. We report a case of false vocal cord perforation with abscess successfully treated by negative pressure wound therapy after abscess treatment. The result suggests that negative pressure wound therapy can be an alternative or adjunctive approach for larynx perforation when the perforation is difficult to close after conservative therapy.
喉穿孔非常罕见，但可能导致严重的气道并发症，包括气胸、肺炎、纵隔炎和咽后脓肿。如果保守治疗失败，则考虑采用包括带蒂皮瓣重建手术在内的积极治疗方法。负压伤口治疗已用于头颈部手术领域的大面积皮肤缺损、坏死性筋膜炎、咽皮肤瘘、造口裂开、下颌骨放射性骨坏死、乳糜瘘、皮瓣坏死和淋巴管瘤。我们报告了1例假声带穿孔伴脓肿病例，在脓肿治疗后通过负压伤口治疗成功治愈。结果表明，当保守治疗后穿孔难以闭合时，负压伤口治疗可作为喉穿孔的一种替代或辅助治疗方法。
