Hawkins D B
Laryngoscope. 1977 Mar;87(3):339-46. doi: 10.1288/00005537-197703000-00006.
As a result of increased use of prolonged endotracheal intubation, complications of intubation are now being seen more often. Stenosis of the airway may develop at the level of the glottic or subglottic larynx, or in the trachea. Discussions of management do not always distinguish clearly between laryngeal stenosis and tracheal stenosis. Yet, these are two separate entities. Discussions of laryngeal stenosis usually deal with subglottic stenosis, with less emphasis on obstruction at the glottic level. Of 20 patients, 14 adults and six children, with stenosis of the larynx secondary to intubation, we were successful in establishing adequate airways in 16. An analysis of these 20 patients leads to the following conclusions: 1. Scarring in the glottic posterior commissure between the arytenoid cartilages is a frequent cause of laryngeal stenosis after intubation. 2. Endoscopic management can be successful in many cases if it is started early enough, and repeated as often as is necessary. The earlier it is begun, the better the results will be. 3. Indwelling stents which are extremely valuable in laryngeal stenosis from external trauma, may not be as useful in stenosis from endotracheal tube trauma.
由于长期气管插管的使用增加，现在插管并发症更为常见。气道狭窄可能发生在声门或声门下喉水平，或气管内。关于治疗的讨论并不总是能清楚地区分喉狭窄和气管狭窄。然而，这是两个不同的实体。关于喉狭窄的讨论通常涉及声门下狭窄，对声门水平的梗阻关注较少。在20例因插管导致喉狭窄的患者中，14例为成人，6例为儿童，我们成功为其中16例建立了足够的气道。对这20例患者的分析得出以下结论：1. 杓状软骨之间的声门后联合瘢痕形成是插管后喉狭窄的常见原因。2. 如果内镜治疗开始得足够早，并根据需要多次重复，在许多情况下可以取得成功。开始得越早，效果越好。3. 留置支架在外部创伤导致的喉狭窄中非常有价值，但在气管插管创伤导致的狭窄中可能不那么有用。
