摘要
目的 总结采用环状软骨前后裂开加移植物治疗严重声门、声门下后壁狭窄经验。方法 回顾分析唐都医院近 10年来治疗严重声门、声门下后壁狭窄患者 2 5例 ,男 15例 ,女 10例。平均年龄 31岁 (9～ 4 6岁 )。病程平均 2年 (3个月～ 6年 )。 19例曾采用各种喉成形术 1～ 7次 (平均2次 )。全部病例术前均靠气管切开套管呼吸。手术采用喉气管裂开 ,环状软骨板正中裂开 ,加肋软骨 (17例 ) ;肌筋膜、软骨膜或裂层皮片 (15例 ) ;带蒂杓状软骨 (2例 ) ;甲状软骨块 1例。T形管支撑3～ 6个月。结果 2 4例 (96 % )全部治愈拔管 ,恢复功能性发音。 1例伤口感染 ,软骨坏死排出失败。随访 1～ 10年 ,疗效可靠 ,未见再狭窄。结论 严重的声门及声门下后壁狭窄采用环状软骨前后裂开加移植物是比较安全有效的治疗方法。术中注意勿损伤食道壁 ,妥善止血 ,移植物缝合牢固 。
Objective To study the effect of anterior and posterior cricoid splitting interposition grafting for severe glottic and subglottic stenosis Methods This is a retrospective study, from 1991 to 2001 years, 25 patients (male 15,female 10,aged 9 to 46 years) with severe glottic and subglottic stenosis were operated with anterior and posterior cricoid splitting interposition grafting method at Tangdu Hospital All of 25 patients were tracheostomy dependent before reconstruction 19 patients had previously undergone 1 to 7(average 2) surgical procedures The surgical technique consisted of laryngotracheostomy ,cricoid lamina midline vertical incision; rib cartilage graft(17 cases),muscular fasciae, perichondrium or split thickness skin graft (15 cases), pedicle arytenoid cartilage graft (2 cases) and thyroid cartilage graft (1 case) interposition and silicon T tube stenting for 3 to 6 months Results Twenty four patients (96%) were successfully decannulated and got an effective phonation One patient failed decannulation The follow up period ranged from 1 to 10 years All of the 24 patients had a stable airway and effective phonation Conclusions The anteroposterior cricoid split interposition graft technique was a safe and effective method for the treatment of severe glottic and subglottic stenosis Careful split of the cricoid, avoiding injury of esophageal musculature, careful hemostasis, a tight suture graft and using stent were the keys of successful operation
出处
《中华耳鼻咽喉科杂志》
CSCD
北大核心
2004年第4期208-210,共3页
Chinese Journal of Otorhinolaryngology
