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先天性新生儿和婴儿会厌下狭窄的滑动喉气管成形术的长期疗效。

Long-term results of slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants.

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos körút 111, Szeged, 6725, Hungary.

Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos körút 111, Szeged, 6725, Hungary.

出版信息

Int J Pediatr Otorhinolaryngol. 2022 Jul;158:111192. doi: 10.1016/j.ijporl.2022.111192. Epub 2022 May 27.

Abstract

OBJECTIVES

Slide laryngotracheoplasty is an effective, single-step procedure without tracheostomy and stenting for treating high-grade congenital subglottic stenosis in neonates and infants. Long-term outcomes were evaluated to assess the reliability of the procedure performed in this age of rapid development of the laryngeal structures.

METHODS

We report five children who underwent slide laryngotracheoplasty before the age of 4 months, each with >3 years follow-up. Increases of length and bodyweight were systematically assessed. Breathing, swallowing, voice, and overall satisfaction was assessed by a quality of life questionnaire. Voice quality was objectively evaluated by measuring shimmer, jitter, fundamental frequency, and the harmonics-to-noise ratio.

RESULTS

All patients had a stable and adequate airway during follow-up without any additional open airway surgery. The patients' voices were physiological, and the intervention had no negative impact on speech development. Swallowing function was optimally retained, and the patients' bodyweight gain and length were satisfactory. During at least 3 years of observation, the anastomosis remained stable and grew dynamically with the patient.

CONCLUSIONS

Slide laryngotracheoplasty (as a single-step procedure) provides an adequate airway without tracheostomy, grafting, or stenting with good long-term functional results in selected neonates and infants with congenital subglottic stenosis.

摘要

目的

滑动喉气管成形术是一种有效、无需气管切开和支架的单步手术,可治疗新生儿和婴儿的高级别先天性声门下狭窄。评估长期结果以评估在喉结构快速发育的这个年龄段进行该手术的可靠性。

方法

我们报告了 5 名在 4 个月前接受滑动喉气管成形术的儿童,每个儿童均随访>3 年。系统评估了长度和体重的增加。通过生活质量问卷评估呼吸、吞咽、声音和整体满意度。通过测量声扰、抖动、基频和谐波噪声比客观评估语音质量。

结果

所有患者在随访期间均保持稳定且充足的气道,无需进行任何额外的开放气道手术。患者的声音正常,干预对言语发育没有负面影响。吞咽功能得到了最佳保留,患者的体重增加和身高令人满意。在至少 3 年的观察期间,吻合口保持稳定并随患者动态生长。

结论

滑动喉气管成形术(作为单步手术)为先天性声门下狭窄的选定新生儿和婴儿提供了无需气管切开、移植物或支架的充足气道,并具有良好的长期功能结果。

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