喉頭横隔膜症手術におけるステント使用の一工夫

An Operative Expedient for Laryngeal Web

　はじめに

　喉頭横隔膜症は日常臨床で遭遇することは比較的少ない疾患^1,2）であると思われる。治療では，横隔膜を切離したのち再癒着をいかに防ぐかという点がポイントとなる。このためにステントが使用されるが，その用い方については様々な方法が検討されてきた^1〜9）。今回われわれは，ペンローズ・ドレーン・チューブ^TMを応用したステントを用いたので報告する。

Laryngeal web is difficult to treat because simple incision may result in re-adhesion in almost all cases. Several types of a stent had been used to prevent re-adhesion. We applied Pen-Rose type silicon drain tube as a stent with endolaryngeal approach.

This stent has two wings and was used to bend reversely against its original curve. It has theadvantages of easy to trim as necessary. Because the stent was bent reversely, it has the tendency to expand outward and thought to be reasonable dynamically. And it had no trouble about contact granulation because it has no sharp edge in the region which has contact with anterior commissure of the vocal cords.

As the thread which was tied with the stent was tightened on the surface of anterior neck skin, this stent became nearly air way foreign body after stay suture had been detached. From this case, we recon-sidered that the stent was tightened in front of the thyroid cartilage after anterior neck skin was in-cised.