Suplemento Vol.76 (5) Set./Out. 2010
RELATO DE CASO (APENAS APRESENTAÇÃO COMO PÔSTER)
P-690
TÍTULO: ESTENOSIS LARINGEA POR INFECCIÓN GRANULOMATOSA
AUTOR(ES): ESTEBAN ESPÍNOLA , QUIROZ JOSÉ, ARIAS JORGE, PEREZ ENRIQUE, ALARCÓN LETICIA, MEDINA ANDRÉS, LIU TA
INSTITUIÇÃO: CÁTEDRA DE OTORRINOLARINGOLOGÍA Y CIRUGÍA DE CABEZA Y CUELLO.
Larynx estenosis caused by granulomatous infections, management and results.
In our country endemic granulomatous diseases such as tuberculosis, fungal infections and leishmaniasis are common reasons for consultation in the general clinic. It is known that systemic diseases which attack other organs such as the larynx, tuberculosis primarily, Paracoccidioidomycosis, and occasionally in leishmaniasis. They are chronic diseases with torpid evolution involving mainly scar healing in this body. Behavior therapy in this sequel is different traumatic strictures because those are involved in all the laryngeal mucosa and abundant synechiae. Treatment involves resection of the stricture dilation with use of tutors and sometimes-teminal end anastomosis, due to severe fibrosis peritracheal. We set ourselves the goal to show the impact of chronic granulomatous disease as a cause of laryngeal stenosis, type of treatment and its evolution, comparing the post-intubation laryngotracheal stenosis most often.
This is a descriptive retrospective study, analyzing the histories of 6 patients with laryngeal stenosis of granolamatoous infectious etiology out of 45 patients with laryngotracheal stenosis treated during the period of the last 10 years, 3 patients were carriers of fungal infection, 2 patients with leshmaniasis, and 1 patient with tuberculosis, all diagnosed by incisional biopsy treated by endoscopic resection-opening of the narrowed segment of cannula placement over silicone Montgomery T-6 months after completing medical treatment for each
The granulomatous etiology accounted for 15% of stenoses.
All patients from endemic areas. Five of them had laryngeal and one laryngotracheal stenosis. Dx made by biopsy. Everyone was performed open surgery with resection of the stenotic area over the Montgomery cannula placement. Two had initial treatment failure early withdrawal of stent cannula and fall respectively, being relocated to the cannula. In monitoring patients 5 had little scar fibrosis and 1 with vocal cord fixation in all cases with acceptable pulmonary function.
Granulomatous lesions such as tuberculosis, mycosis and leishmaniasis correspond to 15% of laryngotracheal stenosis in our environment.
They are more difficult to treat because most torpid evolution of the disease must be controlled the same, for management of strictures.
They are called "soft stenosis ´ and whose treatment differs from the classical resection and anastomosis or reconstructive resection safer being simple and / or dilatation plus a tutor and the Montgomery cannula for a period of approximately 10 months to a year.
keywords: Estenosis, Larynx, Infections, granulomatous