Remacle M, Marza L, Lawson G
Department of ENT and Head and Neck Surgery, University Hospital of Louvain at Mont-Godinne, Yvoir, Belgium.
Eur Arch Otorhinolaryngol. 1998;255(2):64-7. doi: 10.1007/s004050050020.
Intractable aspiration may require diversion of the airway from the pharynx. The epiglottoplasty procedure involves suturing the epiglottis onto the perimeter of the larynx without creating resistance to the natural lines of force of the epiglottic cartilage. The procedure starts by an anterior subhyoid pharyngotomy. The epiglottis is released from the pre-epiglottic space and the thyroepiglottic ligament is sectioned. The disinsertion is completed in the laryngeal lumen by sectioning the epiglottis on each side by following its edges. The pharyngoepiglottic folds are preserved so as to serve as the rotational axis for the freed epiglottis. The petiole of the epiglottis is anchored to the posterior commissure and the free edge of the epiglottis above the ala and the angle of the thyroid cartilage, while the lateral sides of the suprahyoid epiglottis are sutured to the superior part of the arytenoids. This procedure was performed successfully in three patients with intractable aspiration.
顽固性误吸可能需要将气道与咽部隔开。会厌成形术是将会厌缝合到喉的周边，而不会对会厌软骨的自然力线产生阻力。该手术从前正中舌骨下咽部切开术开始。将会厌从前会厌间隙游离出来，并切断甲状会厌韧带。通过沿着会厌边缘在两侧切断会厌，在喉腔内完成脱开。保留咽会厌襞，作为游离会厌的旋转轴。会厌柄固定于后联合以及甲状软骨翼和角上方的会厌游离缘，而舌骨会上会厌的外侧缝合到杓状软骨的上部。该手术在3例顽固性误吸患者中成功实施。
