von Glass W, Weidenbecher M, Fürstberger W
HNO-Klinik, Universität Erlangen-Nürnberg.
HNO. 1987 Sep;35(9):393-8.
Laminotomy as described by Réthi, and segmental tracheal resection with end-to-end anastomosis have proved useful in the adult for the treatment of stenoses of the larynx. In children, the question arises why these may interfere with the growth of the larynx and trachea. A vertical split of the cricoid cartilage followed by stabilization of the larynx by the temporary introduction of a Montgomery silicone T-tube was carried out on four kittens aged four to six weeks. A segmental tracheal resection with end-to-end anastomosis was performed on other animals of the same age. When the animals had stopped growing, the larynx and trachea were investigated both endoscopically and histologically. Following laminotomy the larynx underwent remodelling, resulting in an oval shape, the lumen being wide and the function of the vocal cords normal. Following segmental resection of the trachea, a circular stenosis was found, as a result of irregular growth of the sutured tracheal cartilages. In none of the animals, however were either functional disorders or respiratory distress to be observed. Thus, laminotomy or segmental resection of the trachea can be employed during the formative years without fear of clinically relevant growth disorders.
如雷蒂所描述的椎板切除术以及气管节段性切除并端端吻合术,已被证明对成人喉狭窄的治疗有用。在儿童中,就会出现这样的问题:为什么这些手术可能会干扰喉和气管的生长。对4只4至6周龄的小猫进行了环状软骨垂直劈开,然后通过临时置入蒙哥马利硅胶T形管来稳定喉部的手术。对相同年龄的其他动物进行了气管节段性切除并端端吻合术。当动物停止生长后,对喉和气管进行了内镜和组织学检查。椎板切除术后,喉部发生重塑,呈椭圆形,管腔宽阔,声带功能正常。气管节段性切除术后,由于缝合的气管软骨不规则生长,出现了环状狭窄。然而,在所有动物中均未观察到功能障碍或呼吸窘迫。因此,在生长发育阶段可以采用椎板切除术或气管节段性切除术,而不必担心会出现临床相关的生长障碍。