声门上成形术在重度先天性喉软化症治疗中的作用

Supraglottoplastyin the treatment of severe laryngomalacia

目的:探讨声门上成形术在重度先天性喉软化症治疗中的疗效。方法:回顾性分析2016年5月—2017年12月接受声门上成形术治疗的重度喉软化症患儿29例。结果:29例患儿平均手术年龄为13.37周,术后26例患儿喉喘鸣、喉梗阻症状明显改善,2例术后喉喘鸣反复发作,予以处理后缓解,1例术后明确双侧声带麻痹,持续喉喘鸣,但无喉梗阻表现;术后随访6个月,26例经口喂养顺利,2例长期鼻饲,1例间断呛奶。结论:声门上成形术是一种有效和安全的治疗重度喉软化症的方法。但必须考虑到存在合并疾病,包括神经系统疾病、遗传代谢性综合征、多级气道阻塞、明显胃食管反流等的患儿比其他无合并症的患儿预后稍差,治疗失败的风险更高。

Objective:To explore the efficacy of Supraglottoplastyin the treatment of severe laryngomalacia.Methods:Review of 29 patients who underwent supraglottoplasty for severearyngomalacia,in our hospital from May 2016 to December 2017.Results:The symptoms of stridor and laryngeal obstruction in 26 patients after operation were significantly improved.Two cases of recurrent stridor after operation were treated and relieved.One case had clear bilateral vocal cord paralysis and continued stridor,but no laryngeal obstruction which performed.26 patients underwent oral feeding,2 patients had long-term nasal feeding,1 case of choking milk.And after 6 months of follow-up,26 patients feeding were improved compared with preoperative.Conclusion:Supraglottoplasty is an effective and safe method to treat severe laryngomalacia.However,it must be considered that there are comorbidities,including neurological diseases,genetic metabolic syndrome,multistage airway obstruction,and obvious gastroesophageal reflux,etc.Patients have a slightly worse prognosis than others without comorbidities,and the risk of treatment failure higher.