RESUMO
Purpose: To describe our experience using virtual reality (VR) and three-dimensional (3D) printing as complements for the surgical planning process of slide tracheoplasty (ST) in patients with congenital tracheal stenosis (CTS). Description: VR and 3D printing are used for the surgical planning of ST as a therapeutic option in three female patients under five years of age with CTS. Evaluation: We assessed the planned surgical procedure, procedural time, postoperative complications, and outcomes, as well as the main surgeon's experience with the use of the applied technologies. Conclusions: The interaction within the VR environment allowed for collaboration of the surgical plan between surgical staff and enhancement of the radiologist-surgeon communication, while procedural simulation with 3D printing prototypes allowed for refining technical abilities for the surgical interventions. Based on our experience, the application of these technologies have added value to the surgical planning of ST and its outcomes in the treatment of CTS.
Assuntos
Traqueia , Realidade Virtual , Humanos , Feminino , Estudos Retrospectivos , Traqueia/cirurgia , Impressão Tridimensional , Resultado do TratamentoRESUMO
Major congenital malformations affecting the larynx and trachea are laryngomalacia, vocal cord paralysis, subglottic hemangioma, congenital laryngeal web, laryngotracheal cleft, congenital tracheal stenoses, tracheal and bronchomalacia. The most frequent acquired diseases are stenotic lesions, mainly subglottic stenosis. In this chapter the main anomalies affecting the airway of children and adolescents are described, emphasizing the importance of early and accurate diagnosis as well as defining the modern treatment options.
Las principales malformaciones congénitas que afectan la laringe y tráquea son la laringomalacia, parálisis de cuerdas vocales, hemangioma subglótico, web laríngeo, hendidura laringotraqueal, estenosis traqueal congénita, traqueo y broncomalacia. Las lesiones adquiridas que con mayor frecuencia debemos diagnosticar y tratar son las lesiones post intubación, principalmente la estenosis subglótica. En este capítulo se describen estas afecciones de la vía aérea del niño, haciendo énfasis en la importancia de un diagnóstico precoz y preciso además de definir las alternativas modernas de tratamiento.
Assuntos
Humanos , Criança , Doenças da Laringe/cirurgia , Doenças da Traqueia/cirurgiaRESUMO
Introducción: La estenosis traqueal congénita (ETC) es una entidad clínica infrecuente, que se caracteriza por la presencia de anillos traqueales circulares completos, que determinan estrechez fija del lumen traqueal ocasionando dificultad respiratoria de grado variable. Objetivos: Comunicar 10 pacientes portadores de ETC, sus aspectos clinicos, morfológicos y alternativas en el tratamiento. Pacientes y Método: Se analizó retrospectivamente las formas de manifestación, exámenes diagnósticos y evolución de diez pacientes portadores de ETC diagnosticados entre los años 1998 y 2006. Resultados: Seis pacientes con síntomas respiratorios graves requirieron cirugía correctora de la traquea, uno falleció luego de un año, en el postoperatorio de una intervención cardiovascular. Cuatro pacientes con sintomatología respiratoria menor no requirieron corrección quirúrgica, uno falleció en el postoperatorio de una cirugía cardiaca. Conclusión: La ETC es una malformación potencialmente grave que requiere tratamiento quirúrgico en los pacientes sintomáticos con obstrucción severa de vía aérea. Los pacientes con síntomas leves pueden permanecer en control y no ser sometidos a cirugía correctora.
Congenital tracheal stenosis (CTS) constitutes an uncommon disease, characterized by the presence of complete tracheal rings that determine a fixed narrow tracheal lumen with different levels of respiratory distress. Objective: To expose 10 patients with CTS in relation to their morphological-clinical aspects and treatment alternatives. Method: Retrospective analysis of these patients diagnosed with CTS between 1998 and 2006, in terms of clinical evolution and diagnostic exams. Results: 6 patients with severe respiratory symptoms needed corrective tracheal surgery; one of them died one year later during cardiac surgery. 4 patients with mild respiratory symptoms did not require tracheal surgery; one of them died during cardiac surgery. Conclusion: CTS is a serious malformation that requires surgical treatment in those patients with severe airway obstruction. Patients with mild symptoms are observed closely without the need for surgery.