Scar contracture prevention with local steroid injections in transoral videolaryngoscopic surgery
Scar contracture prevention with local steroid injections in transoral videolaryngoscopic surgery
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DOI：
10.1016/j.anl.2020.02.007
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发表时间：
2020-10-01
影响因子：
1.7
通讯作者：
Shiotani, Akihiro
中科院分区：
文献类型：
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作者：
Uno, Kosuke;Tomifuji, Masayuki;Shiotani, Akihiro
目的：本研究的目的是评估局部类固醇注射，以防止瘢痕挛缩后，经口视频喉镜手术（TOVS）在下咽癌patients.Methods的有效性和安全性：患者参加了这项研究，如果他们接受了局部类固醇注射在TOVS，并参加了门诊至少三个月后。所有患者均接受下咽癌治疗，并使用21号针头注射曲安奈德。进行回顾性病历审查，并对瘢痕挛缩、咽部狭窄、声带运动和不良事件的程度进行评价。瘢痕挛缩进行了评估，使用评分系统，比较治疗和配对对照groups.Results的内镜检查结果：共20例患者接受局部类固醇注射TOVS期间，并参加了治疗。在14例患者（70%）中观察到瘢痕挛缩;然而，与对照病例相比，瘢痕挛缩的程度显著降低。在5名患者中观察到声带不动，但没有发现咽部狭窄。不良反应，如术后咽喉炎或颈椎炎，被认为是在三个病人谁曾接受过切除的固有肌层或最终irradiation.Conclusion：局部类固醇注射TOVS过程中显着降低了术后瘢痕挛缩的程度。然而，在TOVS期间使用局部类固醇注射治疗时应谨慎，因为这可能使已经接受治疗的患者的伤口愈合复杂化。(C)2020日本耳鼻喉科学会Elsevier B. V.出版，保留所有权利。
Objective: The aim of this study was to evaluate the efficacy and safety of local steroid injections to prevent scar contracture after transoral videolaryngoscopic surgery (TOVS) in hypopharyngeal cancer patients.Methods: Patients were enrolled in this study if they had received a local steroid injection during TOVS and had attended an outpatient clinic after at least three months. All patients were being treated for hypopharyngeal cancer and received a single session of triamcinolone acetonide, injected using a 21-gage needle. Retrospective chart reviews were performed, and the degree of scar contracture, pharyngeal stenosis, vocal fold movements, and adverse events were evaluated. Scar contracture was assessed using a scoring system, which compared the endoscopic findings of treatment and matched pair control groups.Results: A total of 20 patients received local steroid injections during TOVS and were enrolled in the treatment. Scar contracture was seen in 14 patients (70%); however, the degree of scar contracture was significantly decreased when compared to control cases. Vocal fold immobility was observed in five patients, but no pharyngeal stenosis was noted. Adverse effects, such as postoperative laryngeal chondritis or cervical spondylitis, were seen in three patients who had previously been treated with resection to the muscularis propria or definitive irradiation.Conclusion: Local steroid injection during TOVS significantly reduced the degree of postoperative scar contracture. However, caution should be used when treating with local steroid injection during TOVS, as this may complicate wound healing in patients who have already received treatment. (C) 2020 Oto-Rhino-Laryngological Society of Japan Inc. Published by Elsevier B.V. All rights reserved.