頁籤選單縮合
題 名 | Neonatal Vallecular Cyst: Report of Eleven Cases=新生兒喉谿部囊腫:十一例報告 |
---|---|
作 者 | 劉秀金; 李國森; 許瓊心; 洪漢陽; | 書刊名 | 長庚醫學 |
卷 期 | 22:4 1999.12[民88.12] |
頁 次 | 頁615-620 |
分類號 | 417.6884 |
關鍵詞 | 喉谿部囊腫; 續發性軟喉症; 喉纖維內視鏡; 上喉部整形手術; Vallecular cyst; Secondary laryngomalacia; Fibrolaryngoscopy; Supraglottoplasty; |
語 文 | 英文(English) |
中文摘要 | 背景:喉谿部囊腫在嬰幼兒是相當罕見的,雖為良性的疾病,但若沒有及早診斷 及妥善的治療,仍有可能造成嚴重的呼吸道阻塞甚至死亡。此回溯性的研究主要是分析喉谿 部囊腫在新生兒所造成的臨床表徵,同時探討其處理原則。 方法:自1993年6月到1997年l月,總共收集了11個喉谿部囊腫的病例,其中有8個男嬰, 3個女嬰。所有的病例均利用喉纖維內視鏡來做診斷及追蹤。我們主要針對其臨床表現,症 狀出現的年齡,診斷時的年齡,以及手術的處理加以分析。 結果:11個病人中均有喘鳴及呼吸窘迫的現象,其中有10個病人有呼吸吵雜、餵食困難及 生長遲緩的表現。發病年齡從出生到2個月大,診斷時的年齡為23天到3個月大。我們利用 喉纖維內視鏡來做診斷時,發現有10個病人合併有不同程度的軟喉症。總共有10個病人接 受二氧化碳雷射去頂手術,其中4個合併軟喉症形態A+C以及1個合併嚴重的軟喉症形態C 者同時接受上喉部整形手術。病人的臨床症狀以及軟喉症的表現於術後均消失,且至今均無 復發。 結論:喉谿部囊腫雖為罕見的疾病,仍需將其列入嬰幼兒喘嗚的鑑別診斷考量之一。喉纖維 內視鏡不僅可以提供我們快速且正確的診斷,也可發現同時併存的呼吸道疾病。本研究發現 有極高比例的喉谿部囊腫同時合併有不同程度的軟喉症,根據其分頻以及接受上喉部整形手 術與否,我們認為軟喉症形態C為續發於喉谿部囊腫壓迫到會厭軟骨所致,只需將囊腫去頂 即可解除軟喉症的症狀;而軟喉症形態A則為原發性的,因此建議若喉谿部囊腫合併軟喉症 形態A時,最好同時做上喉部整形手術。 |
英文摘要 | Background: Vallecular cyst is fairly uncommon in neonates and infants. Although benign in nature, it may cause severe airway obstruction and even death. This study retrospectively analyzed the clinical manifestations of vallecular cyst in neonates and discussed its management. Methods: From June 1993 through January 1997, 11 cases of vallecular cyst were collected and reviewed retrospectively. There were 8 male infants and 3 female infants. Their clinical manifestations, age at the onset of symptoms, age at diagnosis, and surgical management were analyzed. Fibrolaryngoscopy was used for preoperative diagnosis and postoperative follow-up. Results: The infants' initial presentations were inspiratory stridor, respiratory distress, noisy breathing, feeding difficulty, and failure to thrive. There was a high incidence of patients with coexisting signs of laryngomalacia (10/11). Ten patients received laryngomicrosurgery with CO2 laser for deroofing the cyst. Additional supraglottoplasty was performed at the same time in 4 patients with laryngomalacia type A+C and in one patient with severe laryngomalacia type C. Their symptoms all resolved soon after surgery. The phenomenon of laryngomalacia also disappeared. There has been no recurrence up to the present. Conclusion: Although fairly uncommon, vallecular cyst should be included in the differential diagnosis of congenital laryngeal stridor in neonates. The use of fibroendoscopy can promptly diagnose vallecular cyst and any synchronous airway lesions. Although most of the synchronous laryngomalacia (type C) in this study was secondary to vallecular cyst, we suggest that supraglottoplasty be taken into consideration during cyst deroofing when the signs and symptoms of laryngomalacia type A are also present. |
本系統中英文摘要資訊取自各篇刊載內容。