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.

支撑喉镜下环状软骨切开术治疗新生儿双侧声带麻痹1例

声带麻痹(vocal fold paralysis,VFP)又称喉(神经)麻痹,是支配喉的运动神经功能障碍所致的声带运动缺乏。儿童声带麻痹占儿童喉部先天异常的第二位(仅次于喉软化症),占所有喉先天性疾病的10%。新生儿双侧声带麻痹(bilateral vocal fold paralysis,BVFP)是新生儿期的重症和急症,常表现为喉鸣和呼吸窘迫,如诊断治疗不及时可能会危及生命。BVFP较少见,每年每100万出生中约有0.75例,但它仍然是婴儿呼吸窘迫的一个重要考虑因素。气管切开术是有效的治疗手段,但它带来了长期护理负担,同时也增加了死亡风险。有研究表明,50%以上BVFP患儿在出生后的12个月内有自发恢复的可能,因此任何建立稳定气道的手术都应该对患儿发声和吞咽的能力的影响最小。