Gray S, Miller R, Myer C M, Cotton R T
Department of Otolaryngology and Maxillofacial Surgery, University of Cincinnati College of Medicine, OH.
Ann Otol Rhinol Laryngol. 1987 Sep-Oct;96(5):509-13. doi: 10.1177/000348948709600506.
The field of reconstructive surgery of the laryngotracheal complex has been the object of considerable enthusiasm in recent years. New surgical techniques, better surgical tools, and improved diagnostic skills all have contributed to a more confident approach to severe laryngotracheal stenosis. Just as the surgeon's judgment is crucial for a successful primary laryngotracheal reconstruction, so are his or her skill and judgment vitally important in managing the various problems that frequently are found following reconstructive surgery of the larynx and trachea. These problems, although seemingly minor, may prevent successful decannulation if not managed appropriately. This paper discusses the various problems that have been encountered while achieving decannulation following laryngotracheal reconstruction. An approach to such frustrating problems as suprastomal collapse, granulation tissue, and the inability to decannulate are presented.
近年来，喉气管复合体重建手术领域备受关注。新的手术技术、更好的手术工具以及改进的诊断技能，都有助于更自信地应对严重喉气管狭窄。正如外科医生的判断对于初次喉气管重建手术的成功至关重要一样，其技能和判断力在处理喉气管重建手术后常见的各种问题时也至关重要。这些问题看似轻微，但如果处理不当，可能会妨碍成功拔管。本文讨论了喉气管重建术后实现拔管过程中遇到的各种问题。针对诸如造口上方塌陷、肉芽组织以及无法拔管等令人困扰的问题，提出了相应的解决方法。
