声带外移固定术治疗新生儿继发性双侧声带麻痹1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2025.290

摘要/Abstract

摘要： 目的探讨采用支撑喉镜下声带外移固定术治疗气管食管瘘修补术后出现双侧声带麻痹患儿的疗效。方法患儿行气管食管瘘修补术后出现双侧声带麻痹,伴发严重呼吸困难,考虑医源性损伤可能性大,气管插管状态下保守观察半月后无明显改善,全麻下行支撑喉镜下双侧声带外移固定术,术后给予抗生素预防感染,激素及雾化减轻喉头水肿,抗反流药物抑制食管反流等治疗,气管插管呼吸机支持治疗。结果术后5 d患儿成功拔除气管插管,呼吸恢复正常并顺利出院,术后8个月复查示双侧声带运动基本恢复并拆除缝线。结论新生儿双侧声带麻痹可出现严重呼吸困难,采用支撑喉镜下声带外移固定术治疗新生儿双侧声带麻痹是一种安全、有效、微创的手术方式。

关键词: 支撑喉镜, 声带外移固定术, 气管食管瘘, 双侧声带麻痹

Abstract: Objective To investigate the efficacy of bilateral vocal cord external fixation under suspension laryngoscopy for paediatric patients with bilateral vocal cord paralysis following tracheoesophageal fistula repair. Methods A paediatric patient developed bilateral vocal cord paralysis with severe respiratory distress following tracheoesophageal fistula repair, highly suggestive of iatrogenic injury. After two weeks of conservative observation under tracheal intubation with no significant improvement, Under general anaesthesia, bilateral vocal cord external fixation was performed via laryngoscopy. Postoperatively, antibiotics were administered for infection prophylaxis, corticosteroids and nebulisation to reduce laryngeal oedema, and anti-reflux medication to inhibit oesophageal reflux. Tracheal intubation and ventilator support were maintained. Results The infant was successfully extubated on the fifth postoperative day with restored normal respiration and was discharged. An eight-month follow-up revealed near-complete recovery of bilateral vocal cord mobility, and sutures were removed. Conclusion Bilateral vocal cord paralysis in neonates may present with severe respiratory distress. The laryngeal microlaryngoscope-assisted vocal cord fixation technique represents a safe, effective, and minimally invasive surgical approach for managing this condition.

Key words: Self-retaining laryngoscope, Vocal cord extroversion, Tracheoesophageal fistula, Bilateral vocal cord paralysis

中图分类号:

R726.1

李庆亮,窦芬芬,李武轩,王晓杰,康丽丽,孙晓卫. 声带外移固定术治疗新生儿继发性双侧声带麻痹1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(5): 73-77.

LI Qingliang, DOU Fenfen, LI Wuxuan, WANG Xiaojie, KANG Lili, SUN Xiaowei. A case of secondary bilateral vocal cord paralysis treated by external fixation of vocal cord in a newbornand literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(5): 73-77.

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