| Popis: |
Improving the methods of reconstructive plastic surgery, the emergence of new algorithms for managing patients, the development of pharmacology have significantly improved the results of treatment of patients with cicatricial stenosis of the larynx and cervical trachea; however, the problem continues to be relevant since the outcome of treatment is not always satisfactory. The presence of chronic respiratory failure (which often accompanies cicatricial stenosis of the respiratory tract) as well as the lack of supporting viable cartilaginous structures of the larynx and trachea aggravates the course of the disease and requires a differentiated approach to the treatment of extended cicatricial laryngotracheal stenosis. The article analyzes the effectiveness of an integrated approach to the treatment of patients with extended laryngotracheal cicatricial deformity of the lumen using allogeneic graft as well as the correction of respiratory disorders and post-hypoxic tissue changes using inhalations of a heated helium-oxygen mixture in the perioperative period. The study included 20 patients with an age interval of 20–65 years and a disease duration of 1–12 years. At the outpatient stage, the necessary clinical and radiological, endoscopic, and functional examination was carried out. To detect chronic respiratory failure, the gas and acid-base composition of the blood was studied. In the hospital, all patients underwent reconstructive plastic surgery using allogeneic graft. All patients at the pre- and postoperative stage received inhalations with a heated helium-oxygen mixture according to the developed algorithm. The study showed that an integrated approach to the treatment of patients with extended laryngotracheal cicatricial stenoses is an effective method leading to good functional results of surgical treatment, reducing the time of postoperative wound regeneration and improving the quality of life of patients. |
