耳介軟骨を用いて喉頭気管形成術を行った喉頭気管狭窄症の1例

A case of laryngo-tracheal stenosis treated with laryngotracheal reconstruction with auricular cartilage

はじめに

　喉頭気管狭窄症の原因は気管挿管や気管切開術後などの外傷，先天性，炎症性疾患，感染症，腫瘍など，多岐にわたる。その治療については狭窄の程度や発生部位が症例ごとに異なるため，それぞれの病態に応じた治療法を選択する必要がある^1）。今回，われわれは気管切開術後に肉芽を生じ，気管カニューレ抜去困難を生じた患者に対して，耳介の船状窩軟骨を用いて二期的に喉頭気管形成術を行い，良好な結果を得られた症例を経験したので，文献的考察を加えて報告する。

　Laryngo-tracheal stenosis is developed by different causes, such as tracheotomy, long-term endotracheal intubation, congenital inflammatory diseases, infectious diseases, tumors, and others. We presented a case of laryngo-tracheal stenosis, successfully treated by two-stage operation.

　A 52-year-old male presented with granulation tissue around the stoma after tracheotomy. Laryngeal fiberscopy and CT revealed that fracture of the cricoid cartilage and stenosis of the airway by granulation tissue. We performed a two-stage operation. In the first operation, removable of the granulation tissue and fractured cricoid cartilage were performed and created a tracheal groove. Seven months after the first operation, the tracheal groove was closed by a hinged skin flap with a piece of auricular cartilage. Up to the present, there was no recurrence of tracheal.