Morillo P, Vázquez J L, Barberá R, Ros P, Lozano C
UCI Pediatría, Hospital Ramón y Cajal, Madrid.
Cir Pediatr. 1998 Apr;11(2):84-7.
Acquired laryngotracheal stenosis (ALTS) in children is a more and more common disease, following the widespread adoption of prolonged endotracheal intubation for respiratory support, specially among newborn and premature infants with respiratory distress syndrome. Several treatment procedures have been described in order to solve this problem; some authors have recently reported encouraging results with single-stage laryngotracheoplasty, making open reconstruction with airway division, cartilage grafts when appropriate, and closure of the tracheotomy tract at the same operation, followed by a short period of endotracheal intubation, avoiding the need for prolonged laryngeal stenting with its associated risks of granulation tissue formation, restenosis and airway obstruction, and with no need of new surgical procedures. Two patients of 9 and 16 months of age underwent successfully the surgical technique described above, with no need of laryngeal stent; postoperative management required several issues in order to prevent an accidental extubation during the time of scarring of the laryngotracheoplasty. No complications occurred. Follow-up at 6 and 12 months after operation was normal, both ventilation and voice quality.
儿童获得性喉气管狭窄（ALTS）是一种越来越常见的疾病，这是由于延长气管插管用于呼吸支持的广泛应用，特别是在患有呼吸窘迫综合征的新生儿和早产儿中。为了解决这个问题，已经描述了几种治疗方法；一些作者最近报告了单阶段喉气管成形术取得的令人鼓舞的结果，即在同一次手术中进行气道切开的开放性重建、适当的软骨移植以及气管切开通道的闭合，随后进行短期气管插管，避免了长期喉支架置入及其相关的肉芽组织形成、再狭窄和气道阻塞风险，并且无需进行新的外科手术。两名年龄分别为9个月和16个月的患者成功接受了上述手术技术，无需使用喉支架；术后管理需要注意几个问题，以防止在喉气管成形术瘢痕形成期间意外拔管。未发生并发症。术后6个月和12个月的随访显示通气和嗓音质量均正常。
