glottis suture

Glottic suture was first used by Montgmery (1975) to treat severe aspiration. However, the operation is difficult, and the operation must remove the vocal cord mucosa. After the cause of the aspiration is removed, the glottis is opened again. It is difficult to build the vocal cords, and it is difficult to restore satisfactory sound. Therefore, first consider the use of glottic closure or tracheal disconnection to correct aspiration. Treatment of diseases: congenital subglottic stenosis Indication 1, chronic aspiration caused by various reasons, these reasons may be released. 2, the most suitable for children. Contraindications The throat structure has been abnormal. Preoperative preparation 1, X-ray swallowing inspection. 2, lung function check. 3, laryngoscopy. Surgical procedure 1, tracheotomy The patient is lying flat, shoulder pads, and head tilted back. The tracheotomy was performed under local anesthesia, the balloon sleeve was inserted, and the ventilator was used to assist breathing. 2, cutting Re-sterilize the neck with a towel. The transverse incision was made in the middle of the thyroid cartilage, and the subcutaneous layers were cut to expose the lingual-thyroid cartilage. 3, thyroid cartilage splitting, exposing the throat Separated along the anterior thyroid cartilage, the sternohyoid muscle was pulled to the outside to expose the thyroid cartilage and the ring membrane, and the blood vessels at the ring membrane were properly ligated. The perichondrium was cut in the middle of the thyroid cartilage, and a small transverse incision was made in the ring membrane to enter the subglottic cavity. The position of the joint before the clearing of the ring was observed, and the mucosa in the larynx was cut along the anterior joint. 4, cut off the sound, room with mucous membrane, close the glottis Retract the thyroid cartilage wings to the sides with a small hook to expose the bilateral vocal cords and ventricular bands. Cut the vocal cords of the vocal cords and chambers with a small circular scissors. The front end of the vocal cord is sutured to the ipsilateral thyroid cartilage to prevent the vocal cord from shortening. The vocal cords after the thyroid cartilage wing was opposite to the mucosa were pre-positioned with a transverse suture, and the sutures were placed on both sides. The bilateral vocal cord mucosa was sutured intermittently. Remove the small hook to align the bilateral thyroid cartilage wings, tighten the pre-positioned suture and ligature it. 5, close the incision The thyroid cartilage membrane and the sternal thyroid muscle were sutured, and the subcutaneous tissue and the platysma were sutured layer by layer, and the skin incision was sutured.