Emmanuel Ria, Raman Eswaran V, Shivnani Deepa
Department of Otorhinolaryngology and Head and Neck Surgery, Children's Airway and Swallowing Centre, Manipal Hospitals, 98, HAL Airport Road, Bengaluru, India.
Indian J Otolaryngol Head Neck Surg. 2022 Sep;74(3):296-304. doi: 10.1007/s12070-021-02479-y. Epub 2021 Mar 6.
To emphasize the need for high clinical suspicion in the diagnosis of Laryngeal cleft in paediatric population, to catalogue the pattern of presentation, time to treatment and the evolution of surgical techniques for Laryngeal cleft repair at our center. A retrospective review of laryngeal cleft cases which presented over a period of 8 years (May 2012-May 2020), from a tertiary care center, was done. Data includes-patient demographics, preliminary investigations, diagnostic methods, type of cleft, surgical steps and post-operative follow up. Extensive literature search was done and we could not find similar studies from South East Asia and the Indian subcontinents. Of the 10 patients 7 were managed surgically and 3 conservatively. There was an equal distribution of type 1 (n = 5) and 2 (n = 5) clefts. 80% cases were males and 9 out of 10 patients had associated congenital anomalies. 80% cases had symptom resolution (75% were managed surgically and 25% managed medically). Surgical intervention should be based on the extent of anatomical defect and the functional impairment caused by cleft such as respiratory problems, persistence of feeding issues despite maximal medical management and feeding therapy. Early surgical management of type I and II clefts have satisfactory outcomes.
强调在儿科人群中诊断喉裂时提高临床怀疑度的必要性，梳理我院喉裂修复的临床表现模式、治疗时间及手术技术的演变。对一家三级医疗中心8年（2012年5月至2020年5月）期间收治的喉裂病例进行回顾性研究。数据包括患者人口统计学资料、初步检查、诊断方法、裂的类型、手术步骤及术后随访。进行了广泛的文献检索，我们未在东南亚和印度次大陆找到类似研究。10例患者中，7例行手术治疗，3例保守治疗。1型（n = 5）和2型（n = 5）裂分布均衡。80%的病例为男性，10例患者中有9例伴有先天性异常。80%的病例症状得到缓解（75%通过手术治疗，25%通过药物治疗）。手术干预应基于解剖缺陷的程度以及裂造成的功能损害，如呼吸问题、尽管采取了最大程度的药物治疗和喂养治疗仍持续存在的喂养问题。I型和II型裂的早期手术治疗效果令人满意。
