Melley Lauren E, Alnouri Ghiath, Sataloff Robert T
Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.
Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, and Lankenau Institute for Medical Research, Philadelphia, Pennsylvania.
J Voice. 2023 Jan;37(1):110-116. doi: 10.1016/j.jvoice.2020.10.022. Epub 2020 Dec 24.
To introduce a novel surgical technique for the management of posterior glottic stenosis (PGS).
Literature review (PubMed 1973-2020) and case example of a patient treated with novel technique by principal investigator (R.T.S.) RESULTS: Numerous techniques for the treatment of PGS have had varying success. Our patient, a 67-year-old male with a 2-year history of posterior glottic stenosis secondary to multiple, prolonged intubations previously had been treated with several surgical and medical interventions. Three weeks following an additional endotracheal intubation, he presented to our office with PGS recurrence, exhibiting hoarseness, and shortness of breath with any physical activity. He was treated with a silastic sheet placed through a tunnel in the stenosis and sutured posteriorly as a stent. The stent was removed 3 weeks later and the remaining stenosis was divided, successfully treating our patient's PGS with long-term improvement in both respiratory and voice complaints. This led to the design of a stent to be used for this purpose.
This new surgical technique addresses a complex clinical problem and provides otolaryngologists with a minimally invasive option for the surgical treatment of PGS that offers advantages over existing techniques. The two-stage procedure should reduce the risk of recurrence, but more experience is needed. This novel implant may be a valuable tool in the treatment of select patients with mild-moderate PGS.
介绍一种治疗后声门狭窄（PGS）的新型手术技术。
文献综述（PubMed 1973 - 2020）以及主要研究者（R.T.S.）采用新技术治疗的患者病例。结果：治疗PGS的多种技术取得了不同程度的成功。我们的患者是一名67岁男性，有2年因多次长期插管继发后声门狭窄的病史，此前已接受过多种手术和药物治疗。在再次气管插管3周后，他因PGS复发前来就诊，表现为声音嘶哑，且任何体力活动时均有呼吸急促。对他进行的治疗是通过狭窄部位的隧道置入硅橡胶片并在后方缝合作为支架。3周后取出支架，对剩余狭窄部位进行切开，成功治疗了患者的PGS，呼吸和嗓音问题均得到长期改善。这促使设计了一种用于此目的的支架。
这种新的手术技术解决了一个复杂的临床问题，为耳鼻喉科医生提供了一种微创的PGS手术治疗选择，比现有技术具有优势。两阶段手术应可降低复发风险，但还需要更多经验。这种新型植入物可能是治疗部分轻中度PGS患者的有价值工具。
