Charlin B, Dehon A, Bergeron D, Mongeau C J, Grondin P
Department of Otorhinolaryngology, Centre Hospitalier Universitaire de Sherbrooke, Quebec, Canada.
J Otolaryngol. 1987 Dec;16(6):377-81.
Necrosis of the cricoid is a rare complication of tracheal intubation. Almost all cases previously reported were purulent. A 25-year-old man presented with a respiratory distress, two months after 2 days of tracheal intubation. The posterior larynx was the site of a major inflammation with fixity of the arytenoids. After an emergency control of the airway in the acute phase, a posterior cricoid split with widening by a laryngeal stent was performed for treatment of sequelae. Evolutional data from clinical examinations, direct fiberoptic laryngoscopy, CT scan, respiratory function tests, and pathology are described. Successive phases of latency, then acute manifestations, then sequelae can be distinguished. The work-up did not reveal any sign in favor of a septic necrosis. A physiopathologic hypothesis is suggested, explaining the necrosis as an ischemic one, due to destruction of the internal perichondrium vascular network of the cricoid.
环状软骨坏死是气管插管的一种罕见并发症。此前报道的几乎所有病例均为化脓性。一名25岁男性在气管插管2天后两个月出现呼吸窘迫。喉后部是主要炎症部位，杓状软骨固定。在急性期紧急控制气道后，为治疗后遗症进行了环状软骨后部劈开并通过喉支架扩宽。描述了来自临床检查、直接纤维喉镜检查、CT扫描、呼吸功能测试和病理学的演变数据。可区分潜伏期、急性表现期和后遗症期。检查未发现任何支持感染性坏死的迹象。提出了一种病理生理假说，将坏死解释为缺血性坏死，是由于环状软骨内部软骨膜血管网络遭到破坏所致。
