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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 .. >Reflux as a cause of tracheoesophageal puncture failure.
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Reflux as a cause of tracheoesophageal puncture failure.

机译：反流是气管食管穿刺失败的原因。

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OBJECTIVE: To evaluate the response to empiric reflux management in treatment of tracheoesophageal punctures (TEP) failures. METHODS: A retrospective chart review of patients with failed TEP was performed (n = 37). Only those patients without any documented anatomic cause for failure (n = 22) were then further reviewed to determine if empiric treatment for reflux improved voicing. Evidence of reflux was determined by either using video flexible scope of the neopharynx, barium swallows, 24-hour pH probes, and /or transnasal esophagoscopy (TNE). In 13 of 22 patients who had voicing difficulties and no evidence of reflux on these tests, empiric treatment with antireflux medications had been documented. The 22 patients were closely monitored to determine the role of reflux therapy and subsequent voicing outcomes. RESULTS: Of the 22 patients studied, 9 were noted to have granulation tissue on the tracheal side of the prosthesis. All nine patients had complete resolution of the granulation tissue after antireflux treatment, and seven of nine were able to voice again. Of the patients with no obvious reason for TEP failure who were empirically treated for reflux, 62% (8 of 13) had TEP voice after treatment. Seventy-seven percent of our patients (17 of 22) had a positive response to treatment with aggressive reflux therapy. CONCLUSIONS: Previous studies have demonstrated patients with a total laryngectomy and/or radiation therapy have increased reflux. This study addresses reflux as a potential cause of TEP voicing problems. We noted 41% (9 of 22) of patients with voicing difficulties had granulation tissue surrounding the prosthesis as a result of reflux. Aggressive antireflux therapy proved beneficial in eradicating this problem. Prophylactic antireflux therapy may be warranted for patients undergoing TEP to reduce voicing problems.
机译：目的：评估对经验性反流治疗对气管食管穿刺（TEP）失败的反应。方法：对TEP失败的患者进行回顾性图表审查（n = 37）。然后，仅对那些没有任何解剖学上的失败原因（n = 22）的患者进行进一步检查，以确定经验性反流治疗是否能改善发声。可以通过使用新咽部的视频镜，钡餐，24小时pH探头和/或经鼻食道镜（TNE）来确定反流的证据。在这些测试中，有22例发声困难且无反流迹象的患者中，有13例记录了抗反流药物的经验性治疗。密切监测这22例患者，以确定反流治疗的作用和随后的发声结果。结果：在研究的22例患者中，有9例在假体气管侧发现肉芽组织。抗回流治疗后，所有9例患者的肉芽组织均完全消退，其中9例中的7例能够再次发声。在没有明显原因导致TEP失败的患者中，根据经验进行了反流治疗，其中62％（13名患者中的8名）在治疗后有TEP声音。我们的患者中有77％（22名患者中的17名）对积极的反流疗法的治疗反应良好。结论：先前的研究表明，全喉切除和/或放疗的患者反流增加。这项研究解决回流是TEP发声问题​​的潜在原因。我们注意到，有41％（22名患者中有9名）发声困难的患者由于反流而在假体周围形成了肉芽组织。积极的抗反流疗法被证明对消除这一问题有益。接受TEP的患者应采取预防性抗返流治疗，以减少发声问题。

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