电子喉镜在喉部疾病诊治中的应用

目的 :探讨电子喉镜在喉部疾病诊断中的价值及其在喉部疾病治疗中的作用。方法 :采用 PentaxVNL- 15 30型和 Olym pus BF- 2 40型电子喉镜对 3 6 2 8例有喉部症状的患者行喉部检查 ,对 12 2 1例声带息肉、声带小结等喉部疾病患者行电子喉镜下的各种治疗。结果 :3 6 2 8例患者顺利接受了检查 ,并得到诊断。 76 8例声带息肉和 2 49例声带小结患者在电子喉镜下作了息肉或小结的切除 ,113例下咽和喉部的异物患者在电子喉镜下取出异物 ,91例其他喉部疾病患者接受了电子喉镜下的相应治疗。结论 :电子喉镜是喉部疾病诊断和治疗的一种新的有用工具。     

电子喉镜在耳鼻咽喉疾病诊治中的应用

目的探讨电子喉镜在耳鼻咽喉疾病诊断及治疗中的应用价值.方法 采用日本PENTAX EPM-3300型电子喉镜,连接SONY彩色监视器,配电脑图文系统,对1284例耳鼻咽喉疾病患者进行检查,其中喉部检查821例、鼻咽部检查428例、耳部检查35例.对326例声带息肉、声带小结等喉部疾病患者行电子喉镜下的各种治疗.结果 1284例患者顺利检查,并得到了诊断.193例声带息肉、70例声带小结、10例小面积声带白斑在电子喉镜下行切除术,53例咽喉部异物的患者在电子喉镜下取出异物.结论 电子喉镜在耳鼻咽喉疾病诊治中应用广泛,具有实用价值.     

计算机电子鼻咽喉镜在临床中的应用

目的探讨计算机电子鼻咽喉镜在诊治鼻咽、喉部疾病中的临床应用效果.方法用电子鼻咽喉镜对14 865例次鼻咽喉部疾病患者进行检查及治疗,并用计算机图像处理系统G2000对图像进行电脑数字化处理.结果计算机电子鼻咽喉镜可清楚显示鼻咽、喉部的正常结构及鼻咽、喉疾病的病变位置及范围,3591例次患者在镜下得到了满意的治疗,同时可将资料保存,供反复使用.结论计算机电子鼻咽喉镜在临床上不但可用于诊断,而且可用于治疗鼻咽、喉疾病,有较高的应用价值.     

高龄声嘶患者电子喉镜检查

声嘶通常是喉部疾病的早期或首发症状.电子喉镜检查可为喉部疾病的早期诊断,及时治疗提供便利.我们2002年11月～2006年4月对342例60岁以上高龄声嘶患者进行电子喉镜检查,对结果进行分析.     

电子喉镜在声带囊肿切除术中的应用

声带囊肿是引起声嘶的常见病因之一。其治疗方法有显微支撑喉镜或纤维喉镜下声带囊肿切除术。我科从1998年12月～2002年2月采用电子喉镜下检查及治疗喉部疾病15922例，其中声带囊肿切除术73例，疗效满意。报告如下。     

鼻咽纤维喉镜下咽喉部异物取出术

目的探讨检查及治疗喉咽和喉部隐匿或可疑性异物的新手段.方法回顾分析用鼻咽纤维喉镜检查治疗48例喉咽及喉部隐匿或可疑性异物的临床资料.结果48例中46例异物用纤维喉镜一次取出,另2例为局部炎性反应,经消炎治疗后痊愈.结论鼻咽纤维喉镜是检查和治疗喉咽及喉部隐匿性异物的首选方法.     

电子喉镜配合喉息肉钳在喉部手术中的应用

电子喉镜自临床应用以来,在喉部疾病的诊断和治疗上取得了良好的效果。但由于电子喉镜活检钳咬合范围及咬合力较小,钳夹组织少,因此在切除喉部较大病变组织及进行新生物活检时存在局限性。我科自2003年9月～2004年5月在电子喉镜下配合使用喉息肉钳成功克服了上述不足,现将术中应用体会报告如下。     

纤维喉镜下手术1 200例小结

随着光导纤维技术的发展,纤维喉镜在视频监视系统下检查和治疗喉部疾病的技术在国内外迅速开展,以方便、快捷、经济、微创的强大优越性在临床上广泛应用.现将我科2001年1月～2004年6月在视频监视系统纤维喉镜下治疗和诊断喉部疾病1 200例的手术方法和围手术期的处理总结如下.     

奥布卡因在电子喉镜下喉部疾病诊治中的麻醉效果

目的分析比较电子喉镜下喉部疾病诊治中奥布卡因和丁卡因的表面麻醉效果。方法电子喉镜下行喉部疾病诊治患者分别应用奥布卡因和丁卡因行咽喉部黏膜表面麻醉,观察分析患者治疗中配合程度。结果0．4％盐酸奥布卡因组显效率为91．2％,明显优于1％丁卡因组61．7％,两组比较差异具有统计学意义（χ^2=11．42,P〈0．05）。结论奥布卡因应用于电子喉镜下喉部疾病诊治,其麻醉效果好,作用迅速,患者感觉舒适,无痛苦且较为安全。     

支撑喉镜与纤维喉镜在喉部和声带手术中的联合应用

20 0 1年 1月～ 2 0 0 2年 1月 ,我院共行支撑喉镜下喉部声带手术 2 4例 ,其中 8例因患者肥胖、耐受性差、会厌短而柔软等原因 ,使喉腔术野暴露不良 ,经联合应用纤维喉镜后 ,在纤维喉镜照明直视下 ,用支撑喉镜手术器械顺利完成了手术。现报告如下。1 　 资料与方法1 .1 　 临床     

Early surgical intervention in type I laryngeal cleft

ObjectiveDiagnosis and treatment of type 1 laryngeal clefts remains a challenge. The purpose of this study is to determine if early surgical intervention in type I laryngeal clefts improves outcomes.MethodsA retrospective case series was conducted at an academic tertiary care children's hospital. 18 children undergoing early (≤3 months from diagnosis) surgical intervention for type I laryngeal cleft repair between August of 2012 and December 2014. Data was compiled through a manual chart review.Results18 children who underwent early surgical intervention for type I laryngeal cleft repair were identified for review. 14 (78%) were male and 4 (22%) were female and the average age at time of repair was 1.6 years. Most frequent presenting symptoms included dysphagia (61%) and recurrent respiratory issues (22%). Successful swallowing outcomes, defined as subjective improvement (i.e. absence of previous symptoms) per parental report in follow-up visits, +/− normal post-operative MBS (modified barium swallow) findings, was seen in 11 patients (61%). 9 patients required hospitalization for respiratory issues prior to surgical repair. Post-operatively, 4 patients still incurred an admission for respiratory reasons.ConclusionsOur series shows a success rate of 61% with early surgical intervention (≤3 months from diagnosis). A decrease in post-operative hospitalizations is appreciated.     

The usefulness of multislice CT in diagnosis of some laryngeal diseases

The usefulness of helical multidetector computed tomography in diagnosis of some laryngeal and tracheal diseases was presented. Also, the benefits of CT applications in the evaluation of the treatment results were emphasized. Based on the CT images the value of the CT in laryngeal neoplasms, laryngeal and tracheal stenosis and vocal cord paralysis was confirmed. The excellent precision and resolution is helpful in qualification for suitable therapy due to the cancer. In laryngeal and tracheal stenosis helical MDCT helps to choose the treatment strategy as well. In case of vocal cord paralysis this technique is useful in evaluation of the treatment results and prognosis according to the ventilation efficacy.     

原发性喉淀粉样变性4例及文献回顾

目的探讨原发性喉淀粉样变的临床特征及治疗方法。方法回顾性分析空军军医大学附属唐都医院2017年4月—2019年1月收治的喉淀粉样变4例临床资料,并进行相关文献复习。结果4例患者病变组织均经手术切除,其中2例喉正中裂开肿物切除,2例支撑喉镜下二氧化碳激光手术切除,病理结果示淀粉样变,无喉气管功能损伤,无临床及实验证据表明有系统性淀粉样病变。随访时间3个月至2年,未见肿物复发。结论孤立性喉淀粉样变是一种罕见的良性肿瘤,需要同其他良恶性喉肿瘤相鉴别,治疗前需排除全身系统性淀粉样病变。治疗方案以手术为主,治疗策略应该偏保守,以保留器官功能为前提。     

External laryngeal trauma analysis of 392 patients.

BACKGROUND: External laryngeal trauma (ELT) is a rare but clinically important injury. OBJECTIVE: To perform the first population-based, time series analysis of the epidemiology, management, and outcomes of ELT using an 11-state, inpatient sample database containing more than 54 million patients. PATIENTS: Three hundred ninety-two patients with a primary or secondary diagnosis of ELT were identified. Over a 5-year period, the incidence of ELT in this series was 1/137,000. The mean (+/-SD) age was 37 (+/-7) years, and the overall mortality rate was 2.04%. Two hundred forty-eight patients required surgical intervention. RESULTS: The average length of stay for 67 patients not requiring surgical intervention for any injury was 3 (+/-2) days, with no mortality. One hundred eighty patients underwent endoscopy, with 14 requiring tracheotomy alone and 57 requiring tracheotomy plus laryngeal repair. The average length of stay and the mortality rate were higher in these latter groups. Overall, 139 patients underwent tracheotomy, with a mortality rate of 5%, while 96 patients underwent laryngeal repair, with a mortality rate of 1%. Surgical treatment was performed in 140 patients with ELT within 24 hours after presentation, while another 60 received treatment within 48 hours. Associated injuries included skull base or intracranial injury (13%), open neck injury (9%), cervical spine injury (8%), and esophageal or pharyngeal injury (3%). CONCLUSION: External laryngeal trauma is a rare injury, with most patients requiring surgical intervention.     

61例喉癌CT检查与临床病理分期的对比分析

目的 :探讨 CT检查在评价喉癌浸润范围上的作用。方法 :对比观察我院 1995～ 1999年间收治的 6 1例喉癌病人的 CT检查及临床病理分期。声门上癌 11例 (18.0 % ) ,声门癌 47例 (77.1% ) ,跨声门癌 3例 (4 .9% ) ,其 TNM分期 、 、 、 期分别为 32、9、14、6。手术治疗 5 6例 ,放射治疗 5例。结果 :CT诊断符合率为 91.8% (5 6 / 6 1) ,临床分期符合率为 73.8% (4 5 / 6 1) ,两者具有显著性差异 (P <0 .0 5 )。结论 :CT检查对判断喉癌的浸润范围准确可靠 ,对临床分期及制定手术治疗方案具有指导意义。     

成人危重呼吸道阻塞的临床诊断和治疗

目的:探讨成人危重呼吸道阻塞的临床诊断及治疗方案。方法:1995年1月~2006年12月我科收治86例成人危重呼吸道阻塞,采用快速诊断和及时解除呼吸困难的临床处理方法,分析应用该方法的效果。结果:86例危重患者中,炎症性疾病34例,占39.5%;肿瘤性疾病32例,占37.2%;外伤性疾病9例,占10.5%。其他还有喉痉挛3例,喉狭窄6例,双侧声带麻痹2例,鼻咽癌放疗后大出血误吸窒息1例。喉和气管阻塞分别为60例和13例,占69.8%和15.1%。采用气管切开和气管插管分别为46例和4例,占53.5%和4.7%。只采用内科治疗缓解呼吸困难26例。86例患者均于2h内确诊并解除重度呼吸道阻塞。发生严重并发症者14例,发生率为16.3%;手术并发症6例,发生率为6.9%。死亡1例。结论:成人危重呼吸道阻塞的病因复杂,阻塞部位和性质多变,采取快速诊断、及时解除呼吸道阻塞的诊疗方案,是确保疗效的关键。     

Near-total laryngectomy for laryngeal carcinomas with subglottic extension

OBJECTIVE: To investigate whether Pearson classic near-total laryngectomy is a sensible surgical treatment modality for laryngeal carcinomas with subglottic extension. DESIGN: Retrospective analysis of patients treated by near-total laryngectomy in a university hospital that is an academic tertiary health care center. PARTICIPANTS AND INTERVENTION: Medical and computer records of 135 patients who were treated by near-total laryngectomy for laryngeal and hypopharyngeal carcinomas between April 1, 1989, and June 30, 2000, were searched thoroughly, and the final outcomes were confirmed by telephone contact. MAIN OUTCOME MEASURES: Survival rates of the patients with laryngeal carcinomas with subglottic extension treated by near-total laryngectomy were compared with those of the patients with malignancies of other laryngeal regions given the same treatment. RESULTS: Of the 135 patients in the study, 74 were available for determination of 5-year survival. The rate was 65.8% (27/41) for transglottic tumors, 53.8% (7/13) for supraglottic tumors, and 20.0% (4/20) for tumors with subglottic extension. Only 3 of 16 patients with laryngeal carcinomas with supraglottic or transglottic localization died of local recurrence; the rest of the deaths were from regional recurrence or distant metastasis. However, 6 of 13 patients with subglottic extension died of local recurrence, 5 of peristomal recurrence, and only 2 of distant metastasis. CONCLUSIONS: Success was directly related to adherence to precise indications in cancer surgery. While near-total laryngectomy is an effective and reliable treatment modality in laryngeal cancer surgery, its effectiveness in laryngeal cancers with subglottic extension is debatable. These subglottic lesions should be treated by total laryngectomy, which is a more radical surgery.     

婴幼儿喉异物诊治分析

摘要：目的探讨婴幼儿喉异物的诊治方法及误诊原因,提高诊治率,降低误诊率、死亡率。方法回顾性分析我科收治的68例婴幼儿喉异物的临床资料。分析异物部位和种类、检查方法、手术方式、误诊原因等。结果68例患儿均成功取出异物,其中2例行二次手术,无行气管切开或死亡病例。结论提高看护人员及医师对婴幼儿喉异物特点的认识是降低误诊率、死亡率的关键,可疑病例应首选电子喉镜检查,必要时行影像学检查,麻醉及手术方法的选择亦至关重要。     

Rehabilitation of patients with bilateral laryngeal paralysis in a time aspect

According to the literature, up to 15% surgical interventions on the neck is accompanied with such complications as paralysis and paresis of the larynx. Rehabilitation of paralysed larynx by staged surgical treatment and prosthesis lasts for years. Late diagnosis of bilateral laryngeal paralysis after cervical surgery entails persistent systemic poststenotic alterations. The authors offer the diagnosis-treatment algorithm for patients with bilateral laryngeal paralysis which allows a significant reduction in duration of rehabilitation.