O'Riordan Isobel, Francisco Sarah, Rajeev Devika, Peterson Joseph, Ferrari Lynne, Mercier Erika, Watters Karen, Rahbar Reza
Boston Children's Hospital, Department of Otolaryngology and Communication Enhancement, Boston, Massachusetts, USA.
Laryngoscope. 2025 Jun 28. doi: 10.1002/lary.32375.
The management of Type III laryngeal clefts has evolved over the last number of years to include endoscopic approaches in select cases. The aim of our study was to evaluate the outcomes of endoscopically managed Type III laryngeal clefts in terms of repair success, swallowing outcomes, complications, and tracheostomy decannulation rates.
A retrospective review of Type III endoscopic laryngeal cleft repairs was performed over a 15-year period (2007-2021). Data collected included demographic details, number and types of surgical interventions, surveillance airway endoscopy findings, and swallow and tracheostomy outcomes.
Nineteen patients with Type III laryngeal clefts who were treated with endoscopic carbon dioxide laser-assisted repair were included. Median patient age was 9.6 months (0.4-24.1 years) and 52% were male. Thirteen patients (68%) underwent staged repairs of between 1 and 3 procedures in total. Two patients required eventual open repair. Postoperative swallowing outcomes were available for 15 patients (78%) and demonstrated that 12 patients were tolerating thin liquids, 2 patients were thickening, and one remains unable to feed orally.
Endoscopic Type III laryngeal cleft repair is a reasonable alternative to traditional open repair in selected cases. Endoscopic closure allows for repair of Type III clefts in a staged fashion, with 68% of patients in our institution having a successful closure within three stages. In select patients, endoscopic laryngeal cleft repair is a procedure with a low morbidity profile when compared to open repair and should be considered as a surgical option whenever possible.
在过去数年中，Ⅲ型喉裂的治疗方法不断发展，包括在特定病例中采用内镜治疗方法。我们研究的目的是评估内镜治疗Ⅲ型喉裂在修复成功率、吞咽结果、并发症及气管造口脱管率方面的效果。
对15年期间（2007 - 2021年）Ⅲ型内镜下喉裂修复手术进行回顾性研究。收集的数据包括人口统计学细节、手术干预的次数和类型、监测气道内镜检查结果以及吞咽和气管造口结果。
纳入19例接受内镜二氧化碳激光辅助修复治疗的Ⅲ型喉裂患者。患者中位年龄为9.6个月（0.4 - 24.1岁），52%为男性。13例患者（68%）总共接受了1至3次分期修复。2例患者最终需要开放性修复。15例患者（78%）有术后吞咽结果，结果显示12例患者能够耐受稀液体，2例患者需要增稠食物，1例患者仍无法经口进食。
在特定病例中，内镜下Ⅲ型喉裂修复是传统开放性修复的合理替代方法。内镜闭合术允许对Ⅲ型喉裂进行分期修复，在我们机构68%的患者在三个阶段内成功闭合。在特定患者中，与开放性修复相比，内镜下喉裂修复手术的发病率较低，应尽可能将其视为一种手术选择。
