全喉切除术后使用低温保存的同种异体主动脉瓣修复气道的首例:CARE病例报告。

IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY
C Debry, E Brenet, E Martinod, P Lavalle, A Dupret-Bories, P Schultz, L Fath
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引用次数: 0

摘要

病例描述:一名70岁的女性因T4aN2cM0喉癌首次接受了全喉切除术和低温保存的同种异体主动脉移植气道重建。放化疗六个月后,她接受了内窥镜手术,创造了一个新的喉咽。结果:初次手术后13个月,患者昼夜呼吸得到有效恢复,有少量持续的唾液假通道,气管造口术结束后声音低语但可理解。由于持续的康复,吞咽少量软性食物是可能的,尽管正常的进食没有实现。患者未出现肺病发作。总体健康状况良好,无肿瘤复发。讨论:这是首例通过低温保存的同种异体主动脉移植进行喉置换的病例,显示了在长达数十年的气管造口术最终闭合的目标上取得的进展。最终目标是通过改进手术技术的各个方面,尽可能避免主动气道保护系统使手术过程更加复杂,从而实现无假通道吞咽。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
First example of airway restoration using cryopreserved aortic allograft after total laryngectomy: CARE case report.

Case description: A 70 year-old woman presenting T4aN2cM0 laryngeal carcinoma first underwent total laryngectomy with airway reconstruction by cryopreserved aortic allograft. Six months after chemoradiotherapy, she underwent endoscopic surgery to create a neo-laryngopharynx.

Results: At 13 months after primary surgery, day- and night-time breathing was effectively restored, with a little persistent salivary false passage, and a whispering but comprehensible voice after tracheostomy closure. Swallowing was possible for small amounts of soft food, thanks to sustained rehabilitation, although normal feeding was not achieved. The patient showed no episodes of pneumopathy. General health status was good, with no oncologic relapse.

Discussion: This was the first case of laryngeal replacement by cryopreserved aortic allograft, showing progress in the decades-long aim of final tracheostomy closure. The ultimate objective is to achieve swallowing without false passage, by improving various aspects of surgical technique,without, so far as possible, making the procedures more complex by active airway protection systems.

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来源期刊
CiteScore
3.70
自引率
28.00%
发文量
97
审稿时长
12 days
期刊介绍: European Annals of Oto-rhino-laryngology, Head and Neck diseases heir of one of the oldest otorhinolaryngology journals in Europe is the official organ of the French Society of Otorhinolaryngology (SFORL) and the the International Francophone Society of Otorhinolaryngology (SIFORL). Today six annual issues provide original peer reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches and review articles giving most up-to-date insights in all areas of otology, laryngology rhinology, head and neck surgery. The European Annals also publish the SFORL guidelines and recommendations.The journal is a unique two-armed publication: the European Annals (ANORL) is an English language well referenced online journal (e-only) whereas the Annales Françaises d’ORL (AFORL), mail-order paper and online edition in French language are aimed at the French-speaking community. French language teams must submit their articles in French to the AFORL site. Federating journal in its field, the European Annals has an Editorial board of experts with international reputation that allow to make an important contribution to communication on new research data and clinical practice by publishing high-quality articles.
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