Hoasjoe D K, Franklin S W, Aarstad R F, Day T A, Stucker F J
Department of Otolaryngology/Head & Neck Surgery, Louisiana State University School of Medicine, Shreveport 71130, U.S.A.
Laryngoscope. 1997 May;107(5):675-9. doi: 10.1097/00005537-199705000-00022.
Posterior glottic stenosis with arytenoid fixation is an uncommon complication of laryngeal injury. Though etiologies vary; the most common is prolonged intubation. Patients with this problem are tracheotomy dependent and have compromised voice production. There has been no acceptable approach to reconstruction of the larynx, the majority of patients being treated with some type of vocal fold lateralization. The success rate with this approach varies, and this procedure does not take advantage of the intact neuromuscular status of the larynx. Over the past 3 years we have utilized an alternative approach, to repair the stenosis and mobilize the arytenoids in 10 patients. Our surgical technique involves laryngeal exposure via a laryngofissure, the removal of posterior glottic cicatricial tissues, and the application of an autologous graft. Subsequently, all but one of the patients were able to be decannulated. Subjective postoperative voice analysis showed improved voice production. The pathophysiology for this disorder and a review of different treatment modalities are discussed.
伴有杓状软骨固定的声门后狭窄是喉损伤的一种罕见并发症。尽管病因各异，但最常见的是长时间插管。患有此问题的患者依赖气管切开术，且发声功能受损。目前尚无可接受的喉重建方法，大多数患者接受某种类型的声带外移术治疗。这种方法的成功率各不相同，且该手术未利用喉完整的神经肌肉状态。在过去3年里，我们采用了一种替代方法，为10例患者修复狭窄并使杓状软骨活动。我们的手术技术包括通过喉裂开术暴露喉部、切除声门后瘢痕组织以及应用自体移植物。随后，除1例患者外，所有患者均能拔管。术后主观声音分析显示发声改善。本文讨论了该疾病的病理生理学以及不同治疗方式的综述。
