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作者们治疗6例(3～67岁)后天性喉狭窄(声门上1例,声门2例,声门-声门下3例),5例曾用过平常惯用的手术和反复扩张法治疗未效。作者们使用了悬吊式显微喉镜及CO_2激光直接切除瘢痕法;声门上和局限于声门部的狭窄,直接用CO_2激光一期切除一侧的声带、假声带和杓状软骨得到良好效果。对声门-声门下狭窄有环状瘢痕的病例,原来的方法是将环状瘢痕切除后按常规行喉扩张,当时效果看来尚可,但短期即有瘢痕和肉芽组织再长而复发狭窄。故后来对两例行分期手术,即先切除受侵较重的一侧,待上皮再生完全后再切除对侧,如此可减少环状瘢痕形成;考虑术后扩张术亦能引致纤维瘢痕组织形成,故于手术部位注射类固醇激素代替扩张。后又有一些这类病例采用了这种用CO_2激光分期双侧轮换切除并注射激素的方法,结果瘢痕形成少,能得到够用的气道和合用的声音。
The authors treated 6 cases (3 to 67 years) of acquired throat stenosis (1 in the glottis, 2 in the glottis, 3 in the glottis - the glottis) and 5 in the past have used the usual practice of surgery and repeated dilation treatment Not valid. The authors used a suspension microlaryngoscope and a CO_2 laser to directly excise the scar; the supraglottic was limited to the gliding of the glottis, and one-stage excision of the vocal cords, false vocal cords and arytenoid cartilage were performed directly with CO 2 laser Good effect. On the glottis - subglottic stenosis with annular scar cases, the original method is to remove the annular scar conventional laryngeal dilatation, when the effect seems to be acceptable, but in the short term that there is scar and granulation tissue and recurrence of stenosis . So later on the two routine staging surgery, that is, the first removal of the invasion of the heavier side, to be completely resected after epithelial resection of the contralateral, thus reducing the annular scar formation; consider the postoperative expansion can cause fibrous scar tissue formation , So the injection of steroid hormone in the surgical site instead of expansion. Later, some of these cases used the method of staged bilateral rotation with CO 2 laser to excise and inject hormones. As a result, scar formation was scarce and enough airway and combined sound could be obtained.