异形性下小结节狭窄症的长度和位置是否会随着连续内镜干预而改变?
Yasine Mirmozaffari1, Ameer Ghodke2, Rupali N Shah2
1University of North Carolina School of Medicine, Chapel Hill, North Carolina, U.S.A.
The Laryngoscope
|October 3, 2023
概括
针对异常性小结节狭窄症 (iSGS) 的连续内镜手术并没有显著延长狭窄症的长度,也没有改变其与结节的距离. 这一发现影响了长期的iSGS管理策略.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 手术创新 在外科创新.
- 航空航道管理的管理.
背景情况:
- 异常性下狭窄症 (iSGS) 是一种罕见的疾病,影响声带下方的呼吸道.
- 内镜外科干预,包括切除和扩张,是iSGS的主要治疗方法.
- 了解重复手术后狭窄的长期物理变化对于有效的管理至关重要.
研究的目的:
- 评估一系列的内镜外科干预如何影响 subglottic 狭窄的物理维度.
- 评估随着时间的推移,狭窄长度及其与声乐过程的近距离距离的变化.
- 为了确定反复的内镜治疗是否导致iSGS物理参数的显著变化.
主要方法:
- 对52名接受多次内镜手术的ISGS患者 (2014-2022) 的回顾性图表审查.
- 在手术期间测量狭窄的长度和声道过程的近距离距离,在连续治疗中进行了比较.
- 使用非参数方法 (曼·惠特尼U,费舍尔精确,线性回归) 进行了统计分析.
主要成果:
- 在第一和第二次手术之间观察到平均狭窄长度的统计学上显著下降 (p=0.014).
- 从第1到第2次手术中,狭窄的平均长度减少了大约0.11厘米 (p=0.0003).
- 从统计学上看,缩与大脑的距离 (p=0.833) 或随后的手术没有显著变化.
结论:
- 对iSGS的连续内镜切除/扩张似乎不会显著延长内狭窄.
- 尽管进行了多次内镜干预,但狭窄与光的距离在很大程度上没有改变.
- 目前的内镜技术在管理iSGS时是有效的,而不会导致狭窄的有害物理进展.
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