Baron B C, Dedo H H
Laryngoscope. 1980 Dec;90(12):1927-32. doi: 10.1288/00005537-198012000-00002.
Aspiration becomes an intractable problem for some patients who have lost normal neurological function of the glottis. Over the long term, a cuffed tracheotomy tube is inadequate. Several methods have been developed to relieve this problem surgically. These include the use of muscle flaps, tracheoesophageal anastomosis, and use of an epiglottic flap. In this paper, we discuss these previous surgical attempts to alleviate aspiration and present our own technique, which involves creation of a tracheostome and closure of the larynx at the level of the first tracheal ring. This has been used with success in three patients. we feel this technique is less complex and results in less surgical trauma to the larynx, important factors when dealing with critically ill patients. This technique is theoretically reversible by re-anastomosing the trachea to the cricoid cartilage after excising the first tracheal ring.
对于一些声门失去正常神经功能的患者来说，误吸成为了一个棘手的问题。从长远来看，带套囊的气管切开管并不适用。已经开发了几种手术方法来解决这个问题。这些方法包括使用肌瓣、气管食管吻合术和会厌瓣的使用。在本文中，我们讨论了以前减轻误吸的手术尝试，并介绍了我们自己的技术，该技术包括创建一个气管造口并在第一气管环水平关闭喉部。这一技术已在三名患者中成功应用。我们认为该技术操作不太复杂，对喉部造成的手术创伤较小，这在处理重症患者时是重要因素。从理论上讲，在切除第一气管环后，通过将气管重新吻合到环状软骨，该技术是可逆的。
