穿透喉创伤:严重伤害的管理没有开放的减少内部固定
Helen Hieu Nguyen1, Jane Tong2, Andrew Varone3
1School of Medicine, University of Maryland, Baltimore, Maryland, USA.
The Laryngoscope
|June 7, 2025
概括
开放的减少和内部固定 (ORIF) 可能不需要穿透喉创伤. 没有ORIF治疗的严重喉损伤患者的呼吸道,语音和吞功能恢复良好.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 创伤外科 手术 创伤外科
- 喉创伤管理 喉创伤管理
背景情况:
- 甲状腺和状腺软骨骨折,特别是位移或复杂的骨折,通常用开放式减小和内部固定 (ORIF) 进行治疗.
- 透喉创伤可能涉及小软骨碎片,这对ORIF构成挑战.
- 对此类伤害评估替代管理策略至关重要.
研究的目的:
- 为了比较穿透喉创伤的患者在ORIF和没有ORIF的情况下管理的结果.
- 评估严重喉损伤的非手术治疗的有效性.
主要方法:
- 在一级创伤中心 (2012-2022) 治疗喉透创伤的18岁以上患者的回顾性评估.
- 收集的数据包括人口统计,伤害细节和骨折管理.
- 主要结局:气管切除术依赖;次要结局:支架/气管切除术/输卵管切除时间,语音功能,住院.
主要成果:
- 分析了32名患有穿透喉创伤的患者 (97%男性,平均年龄35岁).
- 大多数伤害是高严重度 (81%) 的枪伤 (26/32 Schaefer-Fuhrman组3+).
- 只有5名患者接受了ORIF;20/22名气管切除术被解管,大多数患者的声音功能正常,并恢复了口服饮食.
结论:
- 穿透喉创伤,即使是严重的 (Schaefer-Fuhrman Group 3+),也可以在没有ORIF的情况下有效管理.
- 非操作性管理导致了关于气道,语音和吞的良好结果.
- 这挑战了ORIF对所有移位或复杂喉骨折的传统方法.
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