Laryngotracheal reconstruction in children with subglottic stenosis
10.3760/cma.j.issn.1673-0860.2012.12.003
- VernacularTitle:喉气管重建术治疗儿童声门下狭窄的临床分析
- Author:
Le-Tian TAN
1
;
Qi CHEN
;
Yue-Xin LIN
;
Tian-Yu ZHANG
Author Information
1. 复旦大学附属儿科医院耳鼻咽喉头颈外科
- Keywords:
Laryngostenosis;
Otorhinolaryngologic surgical procedures;
Tissue transplantation;
Child
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2012;47(12):978-981
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effect of laryngotracheal reconstruction (LTR) in children with subglottic stenosis (SGS),and to discuss the indications and the risks of intraoperative and postoperative treatment of LTR.Methods From September 2008 to February 2010,5 children (4 girls and 1 boy,aged 4 to 6 years) were treated by LTR.Among the 5 children,there were 2 congenital SGS and 3 acquired SGS.One had mild grade Ⅲ SGS,3 had severe grade Ⅲ SGS,and one had grade Ⅳ SGS.One child with mild Ⅲ SGS was treated by single-stage LTR,and the rest four children were treated by double-stage LTR.The surgical technique consisted of cricoid lamina midline vertical incision,rib cartilage graft interposition and endotracheal tube (ETT) stenting for 2 to 3 weeks.Results Four children with grade Ⅲ SGS were decannulated 3 months after operation,and the child with grade V SGS got decannulated 6 months after operation.Of all children,rib cartilage graft growed well,and the size of subglottis were amplified by grade Ⅲ SGS to grade Ⅰ SGS,and grade Ⅳ SGS to grade Ⅱ SGS.All children obtained stable airway.One child with grade Ⅳ SGS who had hoarseness got effective phonation during follow-up 2 years after operation.Conclusions LTR is a safe and effective treatment for pediatric subglottic stenosis.The important factors of successful operation are correct assessment and evaluation of the severity and overall medical status and selection of suitable surgical techniques.
