Abstract：
OBJECTIVE: To describe the clinical outcomes of patients who underwent surgical repair through an anterior approach that involved interposition a posterior cartilage for Type III or Type IV laryngotracheoesophageal cleft (LTEC).
METHODS: A chart view was performed on patients with Type III or Type IV LTEC between May 2017 and May 2022. Demographic features and surgical outcomes were collected and analyzed.
RESULTS: Seven patients were finally included. Five patients were diagnosed with Type III LTEC and two patients were diagnosed with Type IV LTEC. All but one patients survived and thrived. Four patients were able to successfully extubate with acceptable voice, and two patients were tracheostomized. Five patients were deemed safe for all consistencies food and one was safe for thickened food. After a mean follow-up of 49 months (18-83 months), neither complications nor recurrences were observed.
CONCLUSIONS: An anterior laryngofissure approach to the cleft repair with a posterior cartilage grafting is an effective and safe treatment for Type III or IV LTEC, which enables closure of LTEC and reconstruction of cricoid plate in order to avoid tracheoesophageal fistula formation or subglottic stenosis postoperatively. Severe tracheomalacia and GERD are two main causes for surgical failure.
METHODS: A chart view was performed on patients with Type III or Type IV LTEC between May 2017 and May 2022. Demographic features and surgical outcomes were collected and analyzed.
RESULTS: Seven patients were finally included. Five patients were diagnosed with Type III LTEC and two patients were diagnosed with Type IV LTEC. All but one patients survived and thrived. Four patients were able to successfully extubate with acceptable voice, and two patients were tracheostomized. Five patients were deemed safe for all consistencies food and one was safe for thickened food. After a mean follow-up of 49 months (18-83 months), neither complications nor recurrences were observed.
CONCLUSIONS: An anterior laryngofissure approach to the cleft repair with a posterior cartilage grafting is an effective and safe treatment for Type III or IV LTEC, which enables closure of LTEC and reconstruction of cricoid plate in order to avoid tracheoesophageal fistula formation or subglottic stenosis postoperatively. Severe tracheomalacia and GERD are two main causes for surgical failure.
摘要：
目的：描述通过前入路手术修复III型或IV型喉气管食管裂（LTEC）后软骨的临床结果。
方法：在2017年5月至2022年5月期间，对III型或IV型LTEC患者进行了图表视图。收集并分析人口统计学特征和手术结果。
结果：最终纳入7例患者。五名患者被诊断为III型LTEC，两名患者被诊断为IV型LTEC。除一名患者外，所有患者都幸存下来并蓬勃发展。四名患者能够以可接受的声音成功拔管，两名患者进行了气管造口术。五名患者被认为对所有一致性食物都是安全的，一名患者对增稠食物是安全的。平均随访49个月（18-83个月）后，未观察到并发症或复发.
结论：喉裂前入路联合后路软骨移植修复裂隙是治疗III型或IV型LTEC的有效且安全的方法，可以闭合LTEC和重建环状软骨板，以避免术后形成气管食管瘘或声门下狭窄。严重的气管软化和GERD是手术失败的两个主要原因。
方法：在2017年5月至2022年5月期间，对III型或IV型LTEC患者进行了图表视图。收集并分析人口统计学特征和手术结果。
结果：最终纳入7例患者。五名患者被诊断为III型LTEC，两名患者被诊断为IV型LTEC。除一名患者外，所有患者都幸存下来并蓬勃发展。四名患者能够以可接受的声音成功拔管，两名患者进行了气管造口术。五名患者被认为对所有一致性食物都是安全的，一名患者对增稠食物是安全的。平均随访49个月（18-83个月）后，未观察到并发症或复发.
结论：喉裂前入路联合后路软骨移植修复裂隙是治疗III型或IV型LTEC的有效且安全的方法，可以闭合LTEC和重建环状软骨板，以避免术后形成气管食管瘘或声门下狭窄。严重的气管软化和GERD是手术失败的两个主要原因。
