甲状软骨翼板在儿童声门下狭窄重建术中的应用

The application of thyroid alar cartilage in the reconstruction of subglottic stenosis for children

目的探讨甲状软骨翼板在儿童声门下狭窄喉气管重建术中的应用。方法回顾性分析2016年9月至2018年7月在空军军医大学唐都医院耳鼻咽喉头颈外科就诊,用甲状软骨翼板作为加宽气道材料行喉气管重建术治疗声门下狭窄的12例患儿的临床资料,男7例,女5例,年龄2.3~12.0岁。对喉气管狭窄程度采用Myer-Cotton气道分度系统进行分度,Ⅱ度4例,Ⅲ度6例,Ⅳ度2例,狭窄平面均位于声门下,部分累及1~2气管环。结果12例患儿中,一次性成功拔管11例,失败1例;其中Ⅱ、Ⅲ度喉气管狭窄均一次性成功拔管,Ⅳ度喉气管狭窄失败1例。无脱管、窒息、伤口不愈合等严重并发症发生。结论对于声门下狭窄患儿,用甲状软骨翼板加宽喉气管腔是安全可靠的,术后不会造成喉腔结构的破坏。

Objective To explore the application value of thyroid alar cartilage(TAC)in the laryngotracheal reconstruction of subglotticstenosis in the paediatric population.Methods Twelve patients(7 males,5 females;range from 2.3 to 12.0 years)with subglotticstenosis who had undergone laryngotracheal reconstruction procedures at our hospital fromSeptember 2016 to July 2018 were analyzed retrospectively.The degree of stenosis was classified according to Myer-Cotton classification system:gradeⅡ(n=4),gradeⅢ(n=6)and gradeⅣ(n=2).The stenosis planes were subglotticbut did not exceed the 3rd tracheal cartilage ring.Results Of all 12 patients,11 were decannulated and 1 failed.All patients with gradeⅡandⅢpatients were decannulated at one procedure.There were no severe complications such as tube dislogement,asphyxia and unhealed wound.Conclusions The TAC for widening laryngotracheal lumen is relatively simple and reliable for laryngotracheal reconstruction in the pediatric population with subglottic stenosis.This would′t cause any structural damage to the laryngeal cavity.