Pearson F G, Brito-Filomeno L, Cooper J D
Ann Otol Rhinol Laryngol. 1986 Nov-Dec;95(6 Pt 1):582-5. doi: 10.1177/000348948609500608.
Since 1973, 28 patients have undergone tracheal and subglottic resection with reconstruction by primary laryngotracheal anastomosis. Nine patients had postintubation stricture, eight had blunt trauma with cricotracheal disruption, seven had a neoplasm, two had an inhalation burn, and two had idiopathic stenosis. In all cases, the anterior cricoid arch was completely resected and a submucosal segment of the posterior cricoid plate was partially resected. A posterior shell of cricoid plate was preserved in 21 patients with intact laryngeal nerve function. Postoperatively, a Montgomery T-tube was used to stent the anastomosis and subglottic area in ten patients, all of whom had residual injury or disease at or immediately below the level of the cords. The proximal arm of the T-tube was positioned above the vocal cords. The tube was removed within 1 month in eight patients and remained for 3 and 18 months in the other two. The extent of resection varied from 2.5 to 7 cm. Tension-relieving procedures were added in 13 cases. Fourteen patients have been followed longer than 5 years, and five patients for more than 10 years. A widely patent anastomosis was maintained in 26 patients. In two patients, a partial restenosis resulted in some limitations of exercise tolerance. Voice and exercise tolerance have not deteriorated with the passage of time. Recurrent laryngeal nerve function was completely preserved in 20 of the 21 patients whose nerve function was intact before operation.
自1973年以来，28例患者接受了气管及声门下切除术，并通过一期喉气管吻合术进行重建。9例患者有插管后狭窄，8例有钝性外伤伴环状软骨气管断裂，7例有肿瘤，2例有吸入性烧伤，2例有特发性狭窄。所有病例均完全切除环状软骨前弓，部分切除环状软骨后板的黏膜下部分。21例喉神经功能完好的患者保留了环状软骨后板的后壳。术后，10例患者使用蒙哥马利T形管支撑吻合口和声门下区域，所有这些患者在声带水平或其下方紧邻处均有残余损伤或疾病。T形管的近端臂位于声带上方。8例患者在1个月内拔除了T形管，另外2例分别保留了3个月和18个月。切除范围为2.5至7厘米。13例患者增加了减张手术。14例患者随访时间超过5年，5例患者随访时间超过10年。26例患者的吻合口保持广泛通畅。2例患者出现部分再狭窄，导致运动耐力有些受限。随着时间的推移，嗓音和运动耐力并未恶化。21例术前神经功能完好的患者中，20例的喉返神经功能得以完全保留。
