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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 .. >Technique, utility, and safety of awake tracheoplasty using combined laser and balloon dilation.
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Technique, utility, and safety of awake tracheoplasty using combined laser and balloon dilation.

机译：结合使用激光和球囊扩张术进行清醒气管成形术的技术，实用性和安全性。

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OBJECTIVES:: Laryngotracheostenosis (LTS) is a condition in which the airway is narrowed between the vocal cords and the carina. We seek to examine whether flexible bronchoscopy with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser incision and balloon dilation tracheoplasty is a practical choice in the management of patients with subglottic or tracheal stenosis. METHODS:: A retrospective chart review was performed at a tertiary care hospital. All subjects with laryngotracheostenosis treated between January 1, 2000, and April 2005 who underwent endoscopic Nd:YAG laser incision and balloon dilation tracheoplasty performed using topical anesthesia and intravenous sedation were included. RESULTS:: A total of 18 patients comprised the study and 36 procedures were performed without complication. Only one procedure was required by eight subjects, while five subjects required two procedures, three subjects had three procedures, one subject had four procedures, and one subject had five procedures until an adequate stable airway was obtained. The average follow-up was 22 months (range 3-55 months). The average body mass index (BMI) was 32.0 kg/m (range = 20.8-42.2 kg/m) and 11 of the 18 subjects (61.1%) were categorized as obese or morbidly obese by BMI criteria. CONCLUSION:: Combined Nd:YAG laser incision and balloon dilation in an awake, spontaneously breathing patient is a safe and effective management tool in the treatment of laryngotracheostenosis. This technique may be particularly beneficial in patients who are at increased risk for general anesthesia such as those with morbid obesity or who have had a history of airway problems during anesthesia.
机译：目的：喉气管狭窄症（LTS）是指声带和隆突之间的气道变窄的情况。我们试图检查使用掺钕钇铝石榴石（Nd：YAG）激光切口和球囊扩张气管成形术的柔性支气管镜检查在声门下或气管狭窄患者的治疗中是否可行。方法：在三级医院进行回顾性图表审查。纳入所有在2000年1月1日至2005年4月之间接受喉镜下气管狭窄治疗的受试者，这些受试者均进行了内镜Nd：YAG激光切口和使用局部麻醉和静脉镇静的球囊扩张气管成形术。结果：共有18位患者组成了该研究，并且进行了36项手术，无并发症。八名受试者仅需要一项程序，五名受试者需要两项程序，三名受试者需要三项程序，一位受试者需要四项程序，一位受试者需要五项程序，直到获得足够的稳定气道。平均随访时间为22个月（范围3-55个月）。平均体重指数（BMI）为32.0 kg / m（范围= 20.8-42.2 kg / m），并且根据BMI标准将18名受试者中的11名（61.1％）分类为肥胖或病态肥胖。结论：Nd：YAG激光切口和球囊扩张术联合用于清醒，自发呼吸的患者是治疗喉气管狭窄的安全有效的管理工具。该技术对于那些全身麻醉风险较高的患者（例如病态肥胖的患者或在麻醉期间有呼吸道问题的患者）尤其有益。

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