[Innovative surgical solutions for laryngeal stenoses in newborns and infants].

Orv Hetil

1 Szegedi Tudományegyetem, Általános Orvostudományi Kar, Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika Szeged, Tisza Lajos krt. 111., 6725.

Published: December 2021

Összefoglaló. A veleszületett légúti szűkületek gyakran kombináltan jelentkeznek, és más szervrendszert is érintő kísérőbetegségekkel, illetve malformációkkal is társulhatnak. Figyelembe véve ezeket a tényezőket, illetve a csecsemőkori légút speciális anatómiáját és sérülékeny szöveteit, a felső légúti szűkületek sebészi kezelése újszülött- és csecsemőkorban igen nagy kihívást jelentő feladat, melynek célja a mihamarabbi definitív, stabil légút biztosítása a hangképzés és a nyelési funkció megőrzésével. A laryngomalacia, a hangszalagbénulás és a subglotticus stenosis együttesen a gége veleszületett rendellenességeinek megközelítőleg 90%-áért felelős. A szerzők erre a három kórképre fókuszálva egy-egy eset kapcsán bemutatják a Szegedi Tudományegyetem Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinikáján működő légútsebészeti munkacsoport által rutinszerűen alkalmazott innovatív sebészi módszereket. A bemutatott sebészeti megoldások egy lépésben, tracheostoma, sztentelés és graft beültetése nélkül azonnali stabil légutat biztosítanak jó hangminőséggel és nyelési funkcióval a supraglottis, a glottis és a subglottis dinamikus és statikus szűkületei esetén egyaránt. Orv Hetil. 2021; 162(52): 2100-2106. Summary. Congenital airway stenoses occur frequently in combinations or may be associated with comorbidities and malformations affecting other organ systems. Considering these factors as well as the special anatomy and vulnerable tissues of the pediatric airway, surgical treatment in neonates and infants is an extremely challenging task. The ultimate goal of the management is to ensure a definitive and adequate airway as soon as possible with the preservation of voice and swallowing. Laryngomalacia, vocal cord palsy and subglottic stenosis together account for approximately 90% of congenital laryngeal disorders. Focusing on these three diseases, the authors - the airway surgery working group at the Department of Otolaryngology and Head and Neck Surgery, University of Szeged, Hungary - present their routinely applied innovative surgical strategies in connection with three cases. The presented 'one-step' surgical solutions provide immediate stable airway with good voice quality and swallowing function without tracheostomy, stenting, or graft implantation for both dynamic and static stenoses of the supraglottis, glottis, and subglottis. Orv Hetil. 2021; 162(52): 2100-2106.

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http://dx.doi.org/10.1556/650.2021.32304DOI Listing

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