The clinical treatment of laryngotracheal rupture injury
Objective:To investigate the therapeutic effect of laryngotracheal rupture injury and management of related complications.Methods:A retrospective analysis was conducted on 10 patients with laryngotracheal rup-ture injury caused by trauma,admitted between October 2014 and October 2022.Results:Anti-shock treatment,local debridement,tracheal-cricoid cartilage or tracheal-tracheal anastomosis,laryngeal cartilage reduction and fix-ation,local transposition flaps repair and phase-Ⅱ airway reconstruction were performed respectively on 10 pa-tients.Nine patients underwent operations of tracheal-cricoid cartilage or tracheal-tracheal anastomosis,with five of these were performed by cartilage broken reduction and fixation,placed with intraluminal stents of iodoform gauze fingerstalls for(8.2±1.6)days.Tracheal reconstruction surgery was performed on 2 cases during phase-Ⅱand both were placed with T-shaped silicone tube to support for 3 months.Two cases required tracheoesophageal fistula surgical repair,and vocal cord suturing was conducted for three vocal fold injuries.Anti-shock treatment was given to one emergency case and closed thoracic drainage treatment was given to another one.We removed the tracheal cannula from 10 patients after surgery and one case was diagnosed with Ⅰ-level swallowing function of sub-water test.All cases recovered to take food per-orally.Conclusion:Maintenance of circulation and respiration functions is the major target during early treatment of laryngotracheal rupture.It should strive to complete the re-construction of airway structure on phase-Ⅰ,among which end-to-end anastomosis to reconstruct airway and bro-ken laryngeal cartilage reduction and fixation are the vital methods for airway structure reconstruction to achieve good results.It is suggested that the reconstruction of trachea and esophagus structures should be performed sim-ultaneously to patients with tracheoesophageal fistula.
万方数据
维普
