外傷性慢性喉頭気管狭窄症の1治験例

TRAUMATIC STRICTURE OF SUBGLOTTIC TRACHEA AND LARYNX

　I．はじめに

　最近交通事故，および労働災害の増加にともない，喉頭，頸部気管の外傷例が急増している。また上記の場合をふくめて，医学各科領域において緊急気管切開の適応が拡がりつつあり，前者における喉頭気管組織の損傷，挫滅による喉頭麻痺や，瘢痕狭窄，後者における不適切な気管切開手術手技による気管の変形や二次感染による組織壊死などの要因が相まつて，上気道の閉塞もしくは狭窄をきたし，套管抜去困難を主訴として，耳鼻咽喉科を訪れる患者が増加してきた。

　われわれは，かような症状を主訴とする複雑な喉頭気管損傷の一症例に対し，喉頭気管形成術を行ない，良好な結果を得たので報告する。

　Owing to the sudden rise in the number of traffic accidents occurring recently, injuries to cervical region, particularly the larynx and trachea have consequently increased. In an emergency treatment of such cases tracheotomy is often called for but, generally speaking, this procedure is likely to be performed in hands that may not be well trained in this field or to paucity of proper after-care that complications such as laryngeal disfugurement, tracheal stricture and even cases of difficult decannulation are being increasingly with.

　The authors report a case of traffic accident that resulted in a bilateral vocal cord paralysis with stricture of the subglottic trachea. The patient was operated for removal of the deformed portion of the larynx and trachea, the healthy tissues were sutured together for a proper healing and, is now completely recovered capable of phonating with the use of his larynx.