喉頭狭窄症の一治験例

A CASE REPORT OF LARYNGEAL STENOSIS SUCCES-SFULLY TREATED

　I．はじめに

　外傷などにもとずく喉頭狭窄の症例は以前からしばしば報告され，その外科的治療も種々工夫されてきている。

　今回われわれは，輪状披裂関節の強直にもとずく，両側声帯の正中位固定に起因した喉頭狭窄症の1例に遭遇し，Woodman氏法^1）では失敗したが，幸い声門前方開大術により，呼吸困難の改善と音声の保存に成功したので，その治療経過の概要を報告し，二，三の検討を加えた。

　A man aged 21 was admitted to our hospital o n January 13, 1976, who was complaining of occasional attacks of choking and difficulty breathing. He had attempted suicide several times in the past.

　By inspection of his larynx, it was found thatboth vocal cords fixted in the median position with a very narrow air way. Tracheotomy was done immediately. His larynx had been observed for about 8 months with conservative therapy, but it showed no change.

　Subsequently, the operation with the lateralization method as described by Woodman was performed, but it was unsuccessful because of ankylosis of the entire laryngeal joints. The second operation with the technique of the widening of the anterior glottal space was performed. The costal cartilage and mucous membrane of the nasal septum were utilized in this operation for the purpose of widening of the anterior glottal space and primarily closure of the wound. His tracheal canula was removed, and he was discharged from the hospital on March 3, 1977. He is now free of dyspnoe in his regular activities, and his voice is adequate for telephone conversation.