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題名 | 先天性後鼻孔閉鎖=Congenital Choanal Artesia |
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作者 | 李國森; 李振川; 黃榮貴; 楊政謙; 張克昌; Lee, Kuo-sheng; Lee, Jehn-chuan; Huang, Jon-kway; Yang, Cheng-chien; Chang, Ko-chang; |
期刊 | 中華民國耳鼻喉科醫學會雜誌 |
出版日期 | 19971200 |
卷期 | 32:6 1997.12[民86.12] |
頁次 | 頁75-81 |
分類號 | 416.87 |
語文 | chi |
關鍵詞 | 後鼻孔閉鎖; 經鼻顯微手術法; 嬰幼兒; Choanal atresia; Transnasal microsurgical approach; Infant; |
中文摘要 | 背景:後鼻孔閉鎖為不常見的先天性異常。本文提出本科的手術治療經驗。 方法:本科自 1991 至 1996 年,收集 12 例( 21 側)後鼻孔閉鎖的病例, 12 例中就其 性別、閉鎖型態、相關先天性異常、手術預後進行分析並分別討論。 結果:12 例( 21 側)中,男嬰 6 例( 50 %),女嬰 6 例( 50 %);雙側閉鎖 9 例 ( 75 %),單側閉鎖 3 例( 25 %);骨性閉鎖者 16 側( 76 %),膜性閉鎖者 5 側 ( 24 %),10 例( 83 %)合併其他相關異常。 8 例( 14 側)接受手術,4 側膜性閉 鎖採經鼻穿刺並擴張術, 10 側骨性閉鎖採經鼻顯微鑽孔手術,術後發生狹窄分別佔 50 % ( 2/4 側)及 40 %( 4/10 側),後經尿道探子施行擴張術 2-4 次,都能維持呼吸道通 暢。 結論:後鼻孔閉鎖的治療以手術為主。手術方法的選擇,依手術者的經驗而有所不同。本科 主張只要能夠存活的小病患,應儘早接受經鼻顯微手術。 |
英文摘要 | Background: Congenital Choanal atresia is an uncommon malformation. This article reports our experience with transnasal microsurgical approach in treating infants with this disease. Method: Over a six-year period of time, from 1991 to 1996, we have diagnosed 12 infants (21 sides) with choanal atresia. Eight of them (14 sides) received surgery and had follow-up postoperatively for at least one year. Records were reviewed and analyzed retrospectively with respect to sex, type of atresia, presence of other congenital anomalies, and prognosis of surgery. Results: Among these 6 male and 6 female patients, there were 9 bilateral atresia and 3 unilateral atresia; bony atresia sumed up to 16 sides, and 5 sides for membraneous atresia. Ten infants (83%) had other abnormalities. Eight of them (14 sides) received operation: 4 sides by transnasal puncture and dilatation, 10 sides by transnasal microsurgical drill-out. Postoperative stenosis occurred in 50% (2/4) and 40% (4/10), respectively. Dilatation with urethral dilator was applied for two to four times to maintain patency of the airway. Conclusion: The mainstay of treatment for congenital choanal atresia is surgery. The choice of operative procedure is individalized. Transnasal microsurgical approach is well documented. Patients should be treated as soon as possible if conditions stable. |
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