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儿童喉气管狭窄的诊断与治疗进展。

Update on the diagnosis and management of pediatric laryngotracheal stenosis.

机构信息

Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

出版信息

Expert Rev Respir Med. 2022 Oct;16(10):1035-1041. doi: 10.1080/17476348.2022.2145947. Epub 2022 Nov 18.

Abstract

INTRODUCTION

Laryngotracheal stenosis comprises a broad spectrum of congenital and acquired conditions that commonly cause pediatric airway obstruction. With the introduction and popularization of operative procedures such as laryngotracheoplasty, cricotracheal resection, and slide tracheoplasty more patients are presenting with airway issues at multiple anatomic levels. A combination of endoscopic and open techniques continues to be utilized for these complex issues. Additionally, there are specific long-term considerations for the post reconstruction patient.

AREAS COVERED

This review highlights important aspects of the diagnosis, work up, and surgical treatment of pediatric laryngotracheal stenosis with updates for revision airway surgery and the post reconstruction patient. Important research articles and techniques within pediatric airway reconstruction are summarized and included in the review, in addition to recent articles from the last five years on pediatric laryngotracheal stenosis which were identified through a search of the PubMed database.

EXPERT OPINION

The multidisciplinary concept of evaluation and treatment of laryngotracheal stenosis continues to be essential. Revision airway surgery presents unique challenges to improve the quality of life of patients as they age after reconstruction. Tracheal transplantation remains an important research area in the treatment of laryngotracheal stenosis.

摘要

简介

喉气管狭窄包括广泛的先天性和后天性疾病,这些疾病通常会导致小儿气道阻塞。随着喉气管成形术、环状气管切除术和滑动气管成形术等手术方法的引入和普及,越来越多的患者在多个解剖部位出现气道问题。这些复杂问题仍然需要结合内镜和开放技术进行治疗。此外,对于重建后的患者还有特定的长期考虑因素。

涵盖领域

本篇综述重点介绍小儿喉气管狭窄的诊断、评估和手术治疗的重要方面,包括气道重建的更新内容和重建后患者的情况。此外,还总结了小儿气道重建领域内的重要研究文章和技术,并对过去五年中与小儿喉气管狭窄相关的重要文献进行了搜索,以便进行综述。

专家意见

喉气管狭窄的多学科评估和治疗理念仍然至关重要。重建后的气道修复术是一个具有挑战性的问题,需要不断提高患者的生活质量。气管移植仍然是治疗喉气管狭窄的一个重要研究领域。

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