Division of Pediatric Otolaryngology Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, U.S.A.
Laryngoscope. 2022 May;132(5):1112-1117. doi: 10.1002/lary.29850. Epub 2021 Sep 17.
OBJECTIVES/HYPOTHESIS: Determine surgical and swallowing outcomes after surgery for type III laryngotracheoesophageal cleft (LTEC).
Case series with chart review.
Chart review was performed on patients with type III LTEC between 2000 and 2019. Demographics, surgical outcomes, and swallowing outcomes were collected and analyzed.
Thirty-three patients met inclusion criteria (28 open and 5 endoscopic repairs). Mean age was 3.4 years for the open group and 0.9 years for the endoscopic group. Seventeen (51.5%) patients had a syndromic diagnosis, most commonly Opitz syndrome and Trisomy 21. Mean follow-up was 33.6 months. Thirteen (39.4%) patients had a previous repair attempt prior to repair at our institution. Twenty-four (70.6%) patients had a tracheostomy prior to or at the time of surgical repair and 13 (38.2%) remain tracheostomy-dependent. Nine patients (27.3%) required a revision cleft repair and four (12.1%) required two revisions. Thirty-one patients had an intact repair at last follow-up (93.9). Two patients died outside the hospital over a year after surgery. Preoperatively 13 of 17 patients with swallowing evaluations aspirated. After repair, 11 of 20 patients were deemed safe for all consistencies and seven were safe for thickened. Endoscopic approaches were performed during the last 2 years of the study and had significantly lower operative time (354.4 minutes vs. 171.5 minutes).
Endoscopic and open approaches are effective for treatment of type III LTEC with 27.3% requiring revision and 93.9% of repairs intact at last follow-up. Overall swallowing outcomes were good in patients who underwent postoperative instrumental swallow evaluation.
4 Laryngoscope, 132:1112-1117, 2022.
目的/假设：确定 III 型喉气管食管裂（LTEC）手术后的手术和吞咽结果。
病例系列和图表回顾。
对 2000 年至 2019 年间患有 III 型 LTEC 的患者进行图表回顾。收集并分析了人口统计学、手术结果和吞咽结果。
33 名患者符合纳入标准（28 例开放性和 5 例内镜修复）。开放性组的平均年龄为 3.4 岁，内镜组为 0.9 岁。17 名（51.5%）患者有综合征诊断，最常见的是 Opitz 综合征和 21 三体。平均随访时间为 33.6 个月。13 名（39.4%）患者在我们机构进行修复之前有过先前的修复尝试。24 名（70.6%）患者在手术修复前或同时有气管造口术，13 名（38.2%）仍依赖气管造口术。9 名（27.3%）患者需要修复裂修复，4 名（12.1%）需要两次修复。31 名患者在最后一次随访时修复完整（93.9%）。两名患者在手术后一年多死于院外。术前 17 名吞咽评估患者中有 13 名吸入。修复后，20 名患者中有 11 名被认为所有稠度都安全，7 名被认为稠度安全。内镜方法在研究的最后 2 年进行，手术时间明显缩短（354.4 分钟比 171.5 分钟）。
内镜和开放性方法对 III 型 LTEC 有效，27.3%需要修正，93.9%的修复完整。在接受术后仪器吞咽评估的患者中，总体吞咽结果良好。
4 级喉镜，132：1112-1117，2022 年。
