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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Predicting decannulation outcomes after distraction osteogenesis for syndromic micrognathia.
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Predicting decannulation outcomes after distraction osteogenesis for syndromic micrognathia.

机译：预测综合征性微棘突的成骨作用后的无褥疮结局。

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OBJECTIVES: To characterize the airway anatomy by upper endoscopy in children with syndromal mandibular hypoplasia and to determine whether predistraction endoscopy is predictive of the likelihood of successful outcomes after mandibular distraction. STUDY DESIGN: Retrospective chart review. METHODS: Assessment of the upper airway by subsites was qualitatively extrapolated into a devised 4-point scale. Upper airways were characterized and evaluated in patients on the basis of decannulation outcomes after distraction. RESULTS: Of the 20 patients, 12 were decannulated, and 6 remain tracheostomy dependent. The average compiled preoperative airway obstruction scores in decannulated patients (2.25) compared with those who failed decannulation (2.36) was not statistically significant (P =.291). A significant change after distraction was noted only at the levels of the oropharynx and supraglottis (P <.001). The average airway scores at these subsites in decannulated patients improved from a mean of 3.46 to 2.17 (P =.002). In patients who failed decannulation, the pre- and postdistraction scores also improved from 3.92 to 2.50 (P =.026). Analysis of the average postdistraction airway scores in decannulated patients (2.17) compared with failures (2.5) failed to reveal a significant difference (P =.375), suggesting that some patients remain tracheostomy dependent despite adequate mandibular expansion. Preoperative airway scores in the two groups were statistically equivocal and, therefore, not predictive of the likelihood of decannulation. CONCLUSIONS: Preoperative airway endoscopy alone is not predictive of the likelihood of successful decannulation after distraction osteogenesis. Comparison of the airway patency after distraction revealed statistically equivocal airway caliber, suggesting that some children fail to advance to decannulation despite adequate mandibular distraction.
机译：目的：通过上内窥镜对患有下颌骨发育不全的儿童进行气道解剖学分析，并确定预分散性内窥镜检查是否可预测下颌骨分散术后成功的可能性。研究设计：回顾性图表审查。方法：将子站点对上呼吸道的评估定性地外推至设计的4分制量表。在分心后，根据患者的上呼吸道狭窄情况对上呼吸道进行特征化和评估。结果：在这20例患者中，有12例被拔除了针头，还有6例仍依赖气管切开术。与未进行通气治疗的患者相比，无通气治疗的患者术前平均气道阻塞评分（2.25）与未通气治疗的患者（2.36）相比无统计学意义（P = .291）。分心后仅在口咽和声门上水平观察到显着变化（P <.001）。无烟气患者中这些亚部位的平均气道评分从平均3.46改善到2.17（P = .002）。在未进行通气治疗的患者中，分心前后的分数也从3.92提高到2.50（P = .026）。对无瓣膜扩张患者（2.17）与失败（2.5）相比，平均分心后气道得分的分析未能显示出显着差异（P = .375），这表明尽管下颌骨有足够的扩张，一些患者仍依赖气管切开术。两组的术前气道评分在统计上是模棱两可的，因此不能预测无球囊扩张的可能性。结论：仅术前气道内窥镜检查不能预测成骨后分散性成功脱管的可能性。分心后气道通畅的比较显示气道口径在统计上是模棱两可的，这表明尽管下颌有足够的分心，但一些儿童仍无法前进至无环。

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