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首页> 外文期刊>The Annals of otology, rhinology, and laryngology >Combined optical coherence tomography and endobronchial ultrasonography for laser-assisted treatment of postintubation laryngotracheal stenosis
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Combined optical coherence tomography and endobronchial ultrasonography for laser-assisted treatment of postintubation laryngotracheal stenosis

机译：光学相干断层扫描和支气管内超声检查相结合的激光辅助治疗插管后喉气管狭窄

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Objectives: We describe the use of combined optical coherence tomography (OCT) and endobronchial ultrasonography (EBUS) to identify the residual hypertrophic tissues and persistent inflammation that are known contributors to stricture recurrence after laser-assisted mechanical dilation (LAMD) of laryngotracheal stenosis (LTS). Methods: Commercially available high-frequency EBUS (approximately 100-μm resolution) and time-domain OCT (approximately 10- to 20-μm resolution) systems were used to visualize airway wall microstructures in the area of hypertrophic tissue formation before and after LAMD in 2 patients with complex circumferential postintubation LTS. Results: Before LAMD, EBUS revealed a homogeneous layer consistent with hypertrophic tissue overlying a hyperechogenic layer corresponding to tracheal cartilage. OCT revealed a homogeneous light backscattering layer and an absence of layered microstructures within hypertrophic tissue. Immediately after LAMD, OCT of the laser-charred tissue showed high backscattering and shadowing artifacts; OCT of noncharred tissue showed bright light backscattering regions that suggested acute inflammation. EBUS revealed thinner but persistent hypertrophic tissue overlying the cartilage. Stenosis recurred in both patients. Conclusions: Intraoperative use of EBUS and OCT could potentially identify residual hypertrophic tissues and persistent inflammation during or after LAMD. It might help physicians predict stricture recurrence, prompting alternative therapeutic strategies and avoidance of repeated endoscopic treatments for LTS.
机译：目的：我们描述了结合使用光学相干断层扫描（OCT）和支气管内超声检查（EBUS）来识别残留的肥大性组织和持续性炎症，它们是造成喉气管狭窄（LTS）的激光辅助机械扩张（LAMD）后狭窄复发的已知原因。 ）。方法：使用市售的高频EBUS（约100μm分辨率）和时域OCT（约10至20μm分辨率）系统可视化LAMD手术前后肥厚组织形成区域的气道壁微结构。 2例患者行复杂的外周LTS插管。结果：在LAMD之前，EBUS揭示了一个与肥大组织一致的均匀层，该层覆盖着对应于气管软骨的超回声层。 OCT显示出肥厚组织内均质的光反向散射层和不存在分层的微结构。在LAMD之后，激光烧焦的组织的OCT立刻显示出高的反向散射和阴影伪影。未烧焦的组织的OCT显示出明亮的反向散射区域，表明存在急性炎症。 EBUS揭示了软骨上方较薄但持续存在的肥大组织。两名患者均出现狭窄。结论：术中使用EBUS和OCT可能会发现LAMD期间或之后残留的肥厚组织和持续性炎症。它可以帮助医生预测狭窄的复发，提示其他治疗策略，避免对LTS进行内镜重复治疗。

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