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[插管后喉部罕见损伤。环杓关节复发性麻痹、扭转和脱位]

[Uncommon injuries of the larynx following intubation. Recurrent paralysis, torsion and luxation of the cricoarytenoid joints].

作者信息

Rudert H

出版信息

HNO. 1984 Sep;32(9):393-8.

PMID:6501014
Abstract

19 laryngeal injuries are reported. 16 were secondary to orotracheal intubation and 3 were sequelae of gastroscopy, laryngoscopy and a nasogastric tube. In 6 patients, the trauma followed prolonged nasotracheal intubation, 10 cases followed a single endotracheal intubation. The main symptom was hoarseness. In 6 cases dislocation of an arytenoid cartilage was diagnosed, in 1 case a vocal cord paresis and in the other cases contusion or distortion of the arytenoid joint. In the cases of subluxation the arytenoid cartilage was dislocated posterolaterally, with the cord in the abducted position. For treatment we recommend closed reduction and injection of Cortison-Crystal-suspension into the joint. The outcome is good after single endotracheal intubation, but bad in prolonged nasotracheal intubation because of ankylosis of the cricoarytenoid joint.

摘要

报告了19例喉部损伤。16例继发于经口气管插管,3例为胃镜检查、喉镜检查和鼻胃管置入的后遗症。6例患者的创伤发生在长时间鼻气管插管之后,10例发生在单次气管插管之后。主要症状为声音嘶哑。6例诊断为杓状软骨脱位,1例为声带麻痹,其他病例为杓状关节挫伤或变形。在半脱位病例中,杓状软骨向后外侧脱位,声带处于外展位。治疗方面,我们建议进行闭合复位并向关节内注射可的松晶体混悬液。单次气管插管后的预后良好,但长时间鼻气管插管后预后较差,因为环杓关节发生了强直。

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