支撑喉镜下CO2激光及几丁糖局部涂布治疗喉狭窄

目的：探讨CO2激光辅以局部几丁糖涂布治疗各种类型喉狭窄的手术方法和疗效。方法：1999年1月-2002年1月在全麻支撑喉镜下共行CO2激光辅以局部几丁糖涂布治疗种类喉狭窄患者21例，其中先天性喉2例，不同原因前联合粘连狭窄13例，后联合璞形成3例，喉乳头状瘤多次手术后喉闭锁2例，甲状腺术后双侧声带外展麻痹行杓状软骨切除术后声门狭窄1例。结果：全部患者术后随访6-24个月，18例拔管保留发声功能；3例再狭窄，2例经再次手术后拔管，无误吸，发声较低沉嘶哑；另一例行喉裂开“T”形管扩张。结论：CO2激光手术 几丁糖局部涂布是一种治疗喉狭窄的有效方法，手术安全简便，可避免颈外进路手术，同时保留较好的发声功能。

Endoscopic Treatment of Laryngostenosis Using Carbon Dioxide Laser and Local Application of Chitosan

Objective To evaluate the technique and effectiveness of endoscopic treatment of laryngostenosis using CO 2 laser and local application of Chitosan.Methods From March 1999 to January 2002,21 patients with laryngostenosis were encountered,including 2 congenital laryngeal web,13 anterior commissure adhesion ,3 posterior glottic stenosis, laryngeal atresia owing to repeated operations for papilloma of larynx,1 postoperative stenosis after arytenoidectomy for bilateral vocal cord paralysis.Results Follow-up period ranged from 6 to 24 months,18 of 21 patients were extubated and reserved nicer vocal quality;two of three patients with restenosis were extubated after second endoscopic laser surgery with normally swallowing function but hoarse voice;the other one patient was treated by silicone T-tubes dilataltion therapy.Conclusion Endoscopic CO 2 laser surgery and local application of Chitosan is an effective and convenient treatment for laryngostenosis.