KHẢO SÁT TÌNH HÌNH ĐIỀU TRỊ SẸO HẸP THANH KHÍ QUẢN TẠI BV TAI MŨI HỌNG TP.HCM

Abstract

Background: There are many causes of airway stenosis in adults. Most common causes are trauma, prolonged intubation, tracheostomy, surgery, radiation therapy, airway burn, tuberculosis,.. Treatment methods including medication to control LPR and surgery to ensure the functioning of the airway. Objectives: to describe clinical characteristics of airways stenosis (laryngotracheal stenosis) and evaluate the effectiveness of surgery treatment at ENT Hospital ofHCMCfrom 2018 to 2022. Subjects: 33 patients. Method: Descriptive cross-sectional study. Results: Cause due to intubation is the highest: 42.4%.
The proportion of men is higher than that of women (72.73% compared with 27.27%). The most common age group is 18-60 years old (51.51%). Tracheal stenosis is 57.6%. The most common fibrous scar lesions are: 81.9%, mainly in intubated patients. The degree of narrow scar is mainly Cotton II (36.4%), Cotton III (27.2%). The length of the lesion is < 1 cm, accounting for 57.6 %. The method of cutting inflammatory granulomatous tissue, cutting the membrane is the most indicated surgery (72.7%), followed by endoscopic balloon dilatation (EBD) (42.4%), Montgomery T-tube stenting (21.2%), cartilage grafting surgery (6.1%), 3 cases underwent tracheal resection and end-to-end anastomosis (9.1%).
Follow-up after 6 months: 71.4% of the T-tube stenting and 76.9% EBD patients were successfully decannulated. There are 2 of 3 cases of tracheal resection and end-to-end anastomosis cases still maintain the therapeutic effect. No patient cartilage grafting showed evidence of restenosis. Conclusion: There are many methods of laryngotracheal correction, but the choice depends on the severity of the stenosis, the patient's comorbidities, and the ability to provide postoperative care.