环状软骨前后裂开加移植物治疗严重声门及声门下狭窄

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 。

环状软骨前后裂开加移植物治疗严重声门及声门下狭窄

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10a来治疗 严重声门、声门下后壁狭窄患者25(男15,女10)例.平均年龄31岁(9～46岁)。病程平均2a(3mo～6a).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(1 例);肌筋膜、软骨膜或裂层皮片(15例);声蒂杓状软骨(2例);甲状软骨块1例.T形管支撑3～6mo.结果:24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1～10a,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 留置支撑器是成功的关键.

Anteroposterior cricoid split interposition costal cartilage grafts for laryngotracheal stenosis in children

Objective: To investigate the effects of anteroposterior cricoid spliting interposition costal grafting for moderate and severe laryngotracheal stenosis in children. Methods: From 1995 to 2005, 87 children (aged 1. 2 to 14 years) with moderate and severe glottic and subglottic stenosis were retrospectively studied. They were operated with cricoid spliting laryngotracheal reconstruction in our hospital. All of 87 patients were tracheostomy-dependent before surgery. Results: Eighty-five patients (95%) were successfully decannnulated and got an effective phonation. The follow-up time was more than 5 years. The effect of operation was satisfactory and the growth and development of children was normal. Conclusion: Anteroposterior cricoid split interposition costal cartilage graft is a safe and effective treatment method for moderate and severe glottic and subglottic stenosis in children.