经颈会厌悬吊术治疗婴儿重度III型喉软化症：可行性、安全性与有效性
Transcervical Epiglottic Suspension for Severe Type III Laryngomalacia in Infants: Feasibility, Safety, and Effectiveness.
文献信息
| PMID | 42835893 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Weiguang Yang |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery Children's Hospital Affiliated to Zhengzhou University (Henan Children's Hospital, Zhengzhou Children's Hospital), Henan Province Engineering Research Center of Early Diagnosis and Precise Treatment of Sleep Disordered Breathing Zhengzhou China. |
| 期刊 | Laryngoscope investigative otolaryngology |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估经颈会厌悬吊术在依赖呼吸支持的III型喉软化症婴儿中的可行性、安全性和临床结局。
方法： 这项单中心三级儿童医院的回顾性病例系列纳入了连续的内镜下确诊的III型喉软化症婴儿，这些婴儿因上气道梗阻而依赖呼吸支持。这些婴儿在2024年1月1日至2025年12月31日期间接受了经颈会厌悬吊术。由于研究期间治疗的所有符合条件婴儿均被纳入，因此未进行先验样本量计算。结局包括手术成功、手术时间、缝线持续时间、围手术期并发症、脱离呼吸支持、避免气管切开、气道梗阻改善、喂养恢复和追赶性生长。
结果： 共纳入15名婴儿。手术时中位年龄为58天。15名婴儿中有14名实现了初次手术成功，所有婴儿在修正手术后均成功。所有婴儿均脱离呼吸支持，无一需要气管切开。术后气道梗阻评分显著改善（p < 0.001）。中位手术时间为20分钟，中位失血量为1 mL，中位缝线持续时间为35天，中位完全经口喂养时间为35天。在10名术前生长受损的婴儿中，8名在最终随访时达到年龄别体重正常状态。不良事件包括2名婴儿缝线过早脱落和1名婴儿轻微皮肤压力性损伤；未发生严重并发症。
结论： 经颈会厌悬吊术在高危III型喉软化症婴儿中是可行的，并与快速脱离呼吸支持和可接受的安全性相关。
证据等级： 4。
英文摘要
OBJECTIVE: To evaluate the feasibility, safety, and clinical outcomes of transcervical epiglottic suspension in respiratory support-dependent infants with Type III laryngomalacia.
METHODS: This retrospective case series at a single-center tertiary children's hospital included consecutive infants with endoscopically confirmed Type III laryngomalacia who were dependent on respiratory support because of upper airway obstruction. These infants underwent transcervical epiglottic suspension between January 1, 2024, and December 31, 2025. Because all eligible infants treated during the study period were included, no a priori sample size calculation was performed. Outcomes included procedural success, operative time, suture duration, perioperative complications, liberation from respiratory support, avoidance of tracheostomy, improvement in airway obstruction, feeding recovery, and catch-up growth.
RESULTS: Fifteen infants were included. Median age at surgery was 58 days. Primary procedural success was achieved in 14 of 15 infants and in all infants after revision. All infants were liberated from respiratory support, and none required tracheostomy. Airway obstruction scores improved significantly after surgery (p < 0.001). Median operative time was 20 min, median blood loss was 1 mL, median suture duration was 35 days, and median time to full oral feeding was 35 days. Among 10 infants with preoperative growth impairment, eight achieved normal weight-for-age status at final follow-up. Adverse events included premature suture detachment in two infants and minor cutaneous pressure injury in one infant; no severe complications occurred.
CONCLUSION: Transcervical epiglottic suspension was feasible and was associated with rapid liberation from respiratory support and an acceptable safety profile in high-risk infants with Type III laryngomalacia.
LEVEL OF EVIDENCE: 4.