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小儿喉狭窄球囊扩张术的治疗结果。

Outcomes of balloon dilation for paediatric laryngeal stenosis.

作者信息

Cantarella Giovanna, Gaffuri Michele, Torretta Sara, Neri Simona, Ambrosini Maria Teresa, D'Onghia Alessandra, Pignataro Lorenzo, Sandu Kishore

机构信息

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Department of Otolaryngology and Head and Neck Surgery, Milan, Italy.

Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2020 Oct;40(5):360-367. doi: 10.14639/0392-100X-N0830.

Abstract

OBJECTIVE

Balloon dilation (BD) is a minimally invasive endoscopic treatment for paediatric laryngeal stenosis (LS) with reduced morbidity compared to open surgery. We retrospectively describe our experience in a cohort of children with chronic LS.

METHODS

Fourteen children (median age: 28.5; range: 2-81 months) with chronic LS (multilevel in 8) were treated with tubeless total intravenous anaesthesia under spontaneous ventilation.

RESULTS

Grade III LS was preoperatively detected in 12 children; the remaining 2 had grade IV stenosis. Six had prior tracheotomy, and one received it during the first intervention. Dilation laryngoplasty was the primary treatment in 11 children and was used as an adjuvant treatment in 3 after open reconstructive surgery. The median number of dilations was 2 (range: 1-6). There were no postoperative complications. At the end of the follow-up (median: 20.5; range: 2-46 months), detectable laryngeal lumen widening and/or respiratory improvement occurred in 12 children. Two of 7 patients with tracheostomy were decannulated.

CONCLUSIONS

Balloon laryngoplasty is a valuable therapeutic option to improve laryngeal patency in children with chronic multilevel LS, both as a primary and secondary adjuvant treatment after reconstructive surgery.

摘要

目的

球囊扩张术(BD)是治疗小儿喉狭窄(LS)的一种微创内镜治疗方法,与开放手术相比,其发病率较低。我们回顾性描述了一组慢性LS患儿的治疗经验。

方法

14例慢性LS患儿(中位年龄:28.5个月;范围:2 - 81个月),其中8例为多级狭窄,在自主通气下接受无管全静脉麻醉治疗。

结果

术前12例患儿诊断为III级LS;其余2例为IV级狭窄。6例曾行气管切开术,1例在首次干预期间接受了气管切开术。11例患儿以扩张喉成形术作为主要治疗方法,3例在开放重建手术后用作辅助治疗。扩张的中位次数为2次(范围:1 - 6次)。无术后并发症。随访结束时(中位时间:20.5个月;范围:2 - 46个月),12例患儿出现可检测到的喉腔扩大和/或呼吸改善。7例气管切开患儿中有2例拔管。

结论

球囊喉成形术是改善慢性多级LS患儿喉通畅性的一种有价值的治疗选择,可作为重建手术后的主要治疗方法和辅助治疗方法。

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