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外伤导致气道狭窄一例并文献复习
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Abstract:
目的：探讨外伤导致气道狭窄的临床特点、诊断及治疗方法。方法：选取我科近期收治的1例外伤导致气道狭窄患者为对象，对其行全麻前联合镜下新生物切除室带粘连松解术，术后进行对症治疗，同时进行随访复查。结果：该患者术后声嘶症状明显改善，呼吸较术前顺畅，无术后复发。结论：气道狭窄的诊断及治疗应加强麻醉科、耳鼻咽喉科等多学科协作，必要时可在手术麻醉前行显微或电子喉镜检查评估气道，避免因未确诊的气道狭窄而造成困难气道的发生。
Objective: To explore the clinical characteristics, diagnosis, and treatment methods of airway stenosis caused by trauma. Methods: A recent case of airway stenosis caused by trauma treated in our department was selected as the subject. The patient underwent a combined pre-anesthesia endoscopic neoplasm resection and ventricular band adhesion release. Postoperative symptomatic treatment was administered, and follow-up examinations were conducted. Results: The patient showed significant improvement in hoarseness postoperatively, with smoother breathing compared to before the surgery, and no recurrence was observed. Conclusion: The diagnosis and treatment of airway stenosis should strengthen multidisciplinary collaboration among anesthesiology, otolaryngology, and other departments. If necessary, a microscopic or electronic laryngoscopy examination can be performed before surgical anesthesia to assess the airway, in order to prevent the occurrence of a difficult airway due to undiagnosed airway stenosis.
| [1] | Kishimoto, Y., Mizuno, K., Kawai, Y., Mizuno, K., Hirabayashi, H., Furukawa, K., et al. (2024) National Epidemiological Survey on Pharyngeal, Laryngeal, and Tracheal Stenosis in Japan: A National Survey on Airway Stenosis. Auris Nasus Larynx, 51, 911-916. https://doi.org/10.1016/j.anl.2024.08.008 |
| [2] | Bitar, M.A., Al Barazi, R. and Barakeh, R. (2017) Airway Reconstruction: Review of an Approach to the Advanced-Stage Laryngotracheal Stenosis. Brazilian Journal of Otorhinolaryngology, 83, 299-312. https://doi.org/10.1016/j.bjorl.2016.03.012 |
| [3] | Peña, J., Cicero, R., Marín, J., Ramírez, M., Cruz, S. and Navarro, F. (2001) Laryngotracheal Reconstruction in Subglottic Stenosis: An Ancient Problem Still Present. Otolaryngology—Head and Neck Surgery, 125, 397-400. https://doi.org/10.1067/mhn.2001.117372 |
| [4] | Carpenter, D.J., Hamdi, O.A., Finberg, A.M. and Daniero, J.J. (2022) Laryngotracheal Stenosis: Mechanistic Review. Head & Neck, 44, 1948-1960. https://doi.org/10.1002/hed.27079 |
| [5] | Gelbard, A., Francis, D.O., Sandulache, V.C., Simmons, J.C., Donovan, D.T. and Ongkasuwan, J. (2014) Causes and Consequences of Adult Laryngotracheal Stenosis. The Laryngoscope, 125, 1137-1143. https://doi.org/10.1002/lary.24956 |
| [6] | Brouns, M., Jayaraju, S.T., Lacor, C., De Mey, J., Noppen, M., Vincken, W., et al. (2007) Tracheal Stenosis: A Flow Dynamics Study. Journal of Applied Physiology, 102, 1178-1184. https://doi.org/10.1152/japplphysiol.01063.2006 |
| [7] | Stephenson, K.A. and Wyatt, M.E. (2016) Glottic Stenosis. Seminars in Pediatric Surgery, 25, 132-137. https://doi.org/10.1053/j.sempedsurg.2016.02.003 |
| [8] | Rao, S.J., Gochman, G.E., Stasyuk, A., Del Rosario, K.L., Cates, D.J., Madden, L.L., et al. (2022) Interventions and Outcomes in Glottic versus Multi‐Level Airway Stenosis: A Multi‐Institutional Review. The Laryngoscope, 133, 528-534. https://doi.org/10.1002/lary.30269 |
| [9] | Nicollas, R. and Triglia, J.M. (2008) The Anterior Laryngeal Webs. Otolaryngologic Clinics of North America, 41, 877-888. https://doi.org/10.1016/j.otc.2008.04.008 |
| [10] | 郑美君, 杨慧, 胡娟娟. 喉显微外科治疗声门型喉蹼的研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 144-147. |
| [11] | Orfanos, J.G. and Quereshy, F.A. (2010) Causes of the Difficult Airway. Atlas of the Oral and Maxillofacial Surgery Clinics, 18, 1-9. https://doi.org/10.1016/j.cxom.2009.11.001 |
| [12] | Uzawa, K., Tokumine, J., Lefor, A.K., Takagi, T., Watanabe, K. and Yorozu, T. (2016) Difficult Airway Due to an Undiagnosed Subglottic Tumor: A Case Report. Medicine, 95, e3383. https://doi.org/10.1097/md.0000000000003383 |
| [13] | Roh, J. (2006) Application of Mitomycin C after Endoscopic Lysis of Congenital Laryngeal Web Combined with Epiglottic Hypoplasia in a Middle-Aged Man. Acta Oto-Laryngologica, 126, 438-441. https://doi.org/10.1080/00016480500395203 |
