Eschapasse H, Lacomme Y, Hassani M, Henry E, Glovaez D, Gaillard J
Acta Chir Belg. 1977 May-Jun;76(3):381-5.
After reviewing their cases of scarr-stenosis of the upper airway between 1966 and 1976 the authors compare laryngeal to tracheal lesions: Laryngeal and laryngo-tracheal stenoses are long and difficult to repair and all too often yield poor results. These stenoses are usually due to technical faults (tracheotomy after prolonged intubation, forced intubation, tracheotomy through the first ring). They are most often avoidable. Pure tracheal stenoses nearly always result from ischemic destruction from the pressure in the balloons of the tubes and cannulae. They are difficult to prevent when resuscitation requires high pressure ventilation. Their treatment however is simple: resection and anastomosis yields excellent results though it should only be performed in pure scarr-tissue stenosis. Endoscopic dilatations may be a necessary preparation.
在回顾了1966年至1976年间他们所治疗的上气道瘢痕狭窄病例后,作者对喉部病变与气管病变进行了比较:喉及喉气管狭窄范围长,修复困难,且常常效果不佳。这些狭窄通常是由技术失误(长时间插管后气管切开、强行插管、经第一气管环行气管切开)所致。它们大多是可以避免的。单纯气管狭窄几乎总是由气管导管和套管气囊压力导致的缺血性破坏引起。当复苏需要高压通气时,很难预防这种情况。然而,其治疗方法很简单:切除并吻合效果极佳,不过仅应在单纯瘢痕组织狭窄时进行。内镜扩张可能是必要的准备措施。