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小儿声门下狭窄的球囊喉成形术:5年经验

Balloon Laryngoplasty for Pediatric Subglottic Stenosis: A 5-year Experience.

作者信息

Önder Şahin Serap, Şahin Yılmaz Aslı, Gergin Özgül, Yılmaz Begüm

机构信息

Department of Otolaryngology, University of Health Sciences, Ümraniye Training and Research Hospital, İstanbul, Turkey.

Department of Otolaryngology, Medipol University Hospital, İstanbul, Turkey.

出版信息

Turk Arch Otorhinolaryngol. 2020 Dec;58(4):208-213. doi: 10.5152/tao.2020.5795. Epub 2020 Dec 1.

Abstract

OBJECTIVE

The objective of this study was to present our experience and evaluate our results of endoscopic balloon laryngoplasty (BL) in children with subglottic stenosis (SGS) at a pediatric tertiary center over a 5-year period.

METHODS

This study reviewed 41 pediatric patients diagnosed with acquired SGS who had undergone BL as the primary course of treatment. Cases were analyzed for details including patient demographics, SGS grade and length, timing and the type of surgery, presence of tracheostomy, comorbidities, postoperative management, complications and outcomes of balloon dilatation.

RESULTS

Forty-one children (22 girls and 19 boys) who had undergone BL at a mean age of 26 months (range, 1 month to 14 years) were included in the study. Nineteen (46.3%) were diagnosed with acute SGS (12 thin stenosis, 7 thick stenosis) and 22 (53.7%) with chronic SGS (9 thin stenosis, 13 thick stenosis). The success rate of BL was 100% in patients with acute and chronic thin membranous stenosis. The effectiveness of BL was significantly higher in patients with acute thick stenosis than in patients with chronic thick stenosis (p=0.016).

CONCLUSION

This study confirms that BL in patients presenting with acquired SGS with thin membranous stenosis, regardless of whether acute or chronic, can have a good prognosis. However, the results are less promising in cases of chronic thick stenosis.

摘要

目的

本研究的目的是介绍我们的经验,并评估在一家儿科三级中心对5年内患有声门下狭窄(SGS)的儿童进行内镜球囊喉成形术(BL)的结果。

方法

本研究回顾了41例被诊断为获得性SGS且已接受BL作为主要治疗方案的儿科患者。对病例进行详细分析,包括患者人口统计学、SGS分级和长度、手术时间和类型、气管切开术的存在情况、合并症、术后管理、并发症以及球囊扩张的结果。

结果

41名儿童(22名女孩和19名男孩)纳入研究,他们接受BL时的平均年龄为26个月(范围为1个月至14岁)。19例(46.3%)被诊断为急性SGS(12例为薄型狭窄,7例为厚型狭窄),22例(53.7%)为慢性SGS(9例为薄型狭窄,13例为厚型狭窄)。急性和慢性薄膜性狭窄患者的BL成功率为100%。急性厚型狭窄患者的BL有效性显著高于慢性厚型狭窄患者(p=0.016)。

结论

本研究证实,对于患有获得性薄膜性狭窄的SGS患者,无论急性还是慢性,进行BL均可有良好预后。然而,对于慢性厚型狭窄病例,结果不太乐观。

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Subglottic Stenosis.声门下狭窄
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Predicting outcomes of balloon laryngoplasty in children with subglottic stenosis.预测声门下狭窄儿童球囊喉成形术的结果。
Int J Pediatr Otorhinolaryngol. 2015 Apr;79(4):532-6. doi: 10.1016/j.ijporl.2015.01.022. Epub 2015 Jan 28.
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Arch Otolaryngol Head Neck Surg. 2012 Mar;138(3):235-40. doi: 10.1001/archoto.2011.1439. Epub 2012 Feb 20.
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Balloon dilation of the pediatric airway: potential for disaster.球囊扩张在儿科气道中的应用:潜在的灾难。
Am J Otolaryngol. 2012 Jan-Feb;33(1):147-9. doi: 10.1016/j.amjoto.2011.05.004. Epub 2011 Jul 23.
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Endoscopic airway management in children.儿童内镜气道管理
Curr Opin Otolaryngol Head Neck Surg. 2008 Dec;16(6):525-9. doi: 10.1097/moo.0b013e3283184479.

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