Division of Otorhinolaryngology, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy.
Division of Otorhinolaryngology, Department of Surgery, Dentistry, Gynecology, and Pediatrics, University of Verona, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126 Verona, Italy.
Am J Otolaryngol. 2022 Mar-Apr;43(2):103280. doi: 10.1016/j.amjoto.2021.103280. Epub 2021 Dec 21.
The aim of this article is to describe step by step the endoscopic treatment of acquired subglottic stenosis (SGS) in an infant and to show the endoscopic results one month after surgery.
Case presentation with instructional video.
University Hospital of Verona, Italy.
We present the case of a 6-month-old ex-26-week preterm female infant who required prolonged intubation in the neonatal period. She referred to our hospital for persistent inspiratory and expiratory stridor, and laboured breathing. The endoscopic dynamic examination of upper airway revealed the presence of type 3 laryngomalacia and subglottic stenosis grade III according to Myers-Cotton classification. An endoscopic balloon laryngoplasty was planned. Two laryngeal dilatations were performed. The endoscopic exploration after the first dilatation showed the presence of a subglottic cyst on the anterior surface of the subglottis. The treatment of subglottic cyst consisted of marsupialization of the cyst with cold microinstruments, and subsequent suction of its content.
An endoscopic check-up was carried out one month after surgery. The examination of the upper airway under spontaneous respiration didn't show significant subglottic stenosis. A very small subglottic cyst under the anterior commissure was observed. However, no more balloon dilatations or marsupialization of the cyst were performed in order to avoid the formation of synechiae.
Treatment of SGS must be planned according to the extent of the stenosis and the history of the patient. Endoscopic procedures, such as balloon dilatation and cyst marsupialization, are best chosen for patients with isolated SGS without prior treatment failure.
本文旨在逐步描述婴儿获得性声门下狭窄（SGS）的内镜治疗方法，并展示术后一个月的内镜结果。
病例报告和教学视频。
意大利维罗纳大学医院。
我们介绍了一名 6 个月大的女性早产儿，她在新生儿期需要长时间插管。她因持续性吸气和呼气喘鸣以及呼吸困难来我院就诊。上气道的内镜动态检查显示存在 3 型杓状软骨软化症和根据 Myers-Cotton 分类的 III 级声门下狭窄。计划进行内镜球囊成形术。进行了 2 次喉扩张。第一次扩张后的内镜探查显示声门下前表面存在声门下囊肿。声门下囊肿的治疗方法包括使用冷微型器械进行囊袋切开术，并随后抽吸其内容物。
术后一个月进行了内镜检查。在自主呼吸下对上气道进行检查，未见明显声门下狭窄。在前联合处观察到一个非常小的声门下囊肿。然而，为了避免粘连的形成，没有进行更多的球囊扩张或囊肿切开术。
SGS 的治疗必须根据狭窄的程度和患者的病史来计划。对于没有先前治疗失败史的单纯 SGS 患者，最好选择内镜手术，如球囊扩张和囊肿切开术。
