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儿童声门下狭窄:来自三级医疗机构的初步经验

Subglottic Stenosis in Children: Preliminary Experience from a Tertiary Care Hospital.

作者信息

Ahmad Latoo Manzoor, Jallu Aleena Shafi

机构信息

Otorhinolaryngology, Head & Neck Surgery, Government Medical College Srinagar, Srinagar, Jammu & Kashmir, India.

出版信息

Int J Otolaryngol. 2020 Dec 15;2020:6383568. doi: 10.1155/2020/6383568. eCollection 2020.

Abstract

INTRODUCTION

This retrospective study describes our experience in the evaluation and management of infants with subglottic stenosis.

MATERIALS AND METHODS

The study included 10 patients aged between 1 wk and 18 months with 6 cases having congenital subglottic stenosis and 4 cases having acquired subglottic stenosis.

RESULTS

6 patients had grade I, 3 patients had grade II, and 1 patient had grade III subglottic stenosis. Tracheostomy was required in 4 patients at the time of presentation. 7 patients were treated successfully with Bougie dilation followed by topical application of mitomycin, whereas 1 patient who failed to serial dilation needed open reconstructive procedure. Laser excision of the anterior subglottic web was performed in one patient. Another patient with underlying cerebral palsy could not be operated upon and was managed with tracheostomy.

CONCLUSION

Subglottic stenosis may be effectively man-aged with endoscopic surgical techniques, although the number of such sittings required varies with the type and severity of stenosis. Open surgical procedures need to be individualised as per the needs of the patient only after all the other endoscopic possibilities have been exhausted.

摘要

引言

本回顾性研究描述了我们在评估和管理声门下狭窄婴儿方面的经验。

材料与方法

该研究纳入了10例年龄在1周龄至18个月之间的患者,其中6例患有先天性声门下狭窄,4例患有后天性声门下狭窄。

结果

6例患者为I级声门下狭窄,3例为II级,1例为III级。4例患者在就诊时需要进行气管切开术。7例患者通过探条扩张并局部应用丝裂霉素成功治疗,而1例连续扩张失败的患者需要进行开放性重建手术。1例患者接受了声门下前部蹼的激光切除术。另1例患有脑瘫的患者无法进行手术,采用气管切开术进行治疗。

结论

声门下狭窄可以通过内镜手术技术有效管理,尽管所需的手术次数因狭窄的类型和严重程度而异。只有在所有其他内镜治疗方法都用尽后,才需要根据患者的需求对开放性手术进行个体化处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d44d/7803111/8fe1255c115b/ijoto2020-6383568.001.jpg

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