小児喉頭狭窄の問題点

抄録

Various controversial problems have been pointed out for the treatment modality for patients with cicatricious stenosis of the larynx as follows : 1) successive change of the autografted mucosa and/or skin, 2) timing of complete closure of the tracheostoma, 3) influence of puberty upon the air-way, and 4) influence of puberty upon vocal functions. Thirty-six patients more than 15-year-old and 23 patienets less than 15-year-old, both with cicatricious stenosis of the larynx, were retrospectively reviewed in this study. As a result, following conclusions were obtained.1) Autografted mucosa/skin can be alive accompanying prominent cicatricious change below the grafted mucosa/skin, suggesting this histopathological change may bring re-stenosis of the air-way. 2) The trachestoma should be closed preferably after puberty, especially for patients undergoing posterior cricoid split (PCS) maneuver. For patients without PCS complete closure in childhood may cause no serious problem. 3) Patients treated their stenosis in childhood may have no restenosis of the air-way even in adulthood. 4) Patient with laryngeal stenosis may experience voice change at puberty as like ordinary children.