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題 名 | Tornwaldt氏囊腫=Tornwaldt's Cyst |
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作 者 | 黃伯光; 何青吟; 林清榮; | 書刊名 | 中華民國耳鼻喉科醫學會雜誌 |
卷 期 | 32:6 1997.12[民86.12] |
頁 次 | 頁82-88 |
分類號 | 416.879 |
關鍵詞 | Tornwaldt氏囊腫; 鼻咽囊腫; 咽囊; Tornwaldt's cyst; Nasopharyngeal cyst; Pharyngeal bursa; |
語 文 | 中文(Chinese) |
中文摘要 | 背景:Tornwaldt 氏囊腫為咽囊開口阻塞後分泌物聚積所形成, 而咽囊則是在胚 胎第 2 個月時,因脊索( notochord )退化與咽部內胚層相連,牽引上皮向內生長所形成 之空腔。由於其症狀表現多樣而複雜,常造成診斷及處置上之困擾。方法:臺北榮民總醫院 自 1982 年 5 月至 1995 年 6 月間,共對 17 例 Tornwaldt 氏囊腫施行手術。 藉由回溯 性病史分析,提出臨床經驗報告,並參考文獻做進一步之討論。結果:患者無顯著性別差異 ,好發年齡群為 55 到 70 歲以及 15 到 30 歲之間,徵侯包括鼻咽症狀 10 例,中耳積水 3 例,頸部腫塊 1 例,頭痛及腦神經麻痺 2 例,另有 1 例並無相關症狀。 所有病例皆是 由反射鏡或鼻咽內視鏡所發現,並根據病理報告得到診斷的確認。 15 名囊腫較小的病人接 受造袋術, 另 2 名囊腫直徑超過 2 cm 的病人則分別接受經口和經 的全切除手術,術後 平均追蹤時間為 15 個月, 全部病例之相關症狀均獲得緩解, 且無復發產生。 結論: Tornwaldt 氏囊腫在診斷上需注意不要誤診為鼻竇炎,且要排除鼻咽癌的可能。至於與其他 鼻咽部囊腫的鑑別診斷,則可藉由病理檢查和發生的位置為之。治療以造袋術或全切除為主 ,預後良好,少有復發報告。 |
英文摘要 | Background: Tornwaldt's cyst results from obstruction of the orifice of the pharyngeal bursa and subsequent accumulation of secretions, debris, or infected material within the bursa. During the sixth week of fetal life, notochordal remnants in the posterior wall of the nasopharynx may communicate with the pharyngeal epithelium. This connection allows ingrowth of respiratory epithelium, which creates the formation of pharyngeal bursa. The detection and evaluation of Tornwaldt's cyst are frequently complicated by the variability and complexity of its clinical presentations. Methods: There were seventeen cases of Tornwaldt's cysts all of which underwent surgical treatment in the Department of Otorhinolaryngology of VGH, Taipei between May 1982 and June 1995. The incidence, clinical features, and treatment of these cases are presented in associated with a review of the literature. Results: No sex predilection was noted. There were two peak incidences in the ranges 55 to 70 years and 15 to 30 years. Clinical features included related nasopharyngeal symptoms in 10 cases, middle ear effusion in 3 cases, cervical lymphadenitis in 1 case, and headache and cranial nerve palsy in 2 cases. One case was detected incidentally without corre-sponding symptoms or signs. All cases were discovered by mirror or endoscopic examination of nasopharynx, and the diagnoses were all confirmed by pathological studies. Surgical Management contained marsupialization in 15 cases and total excision in 2 cases. Complete relief of the symptoms without recurrence was obtained in all cases. Conclusions: Tornwaldt's cyst should not be misdiagnosed as chronic paranasal sinusitis, and it is essential to consider the possibility of nasopharyngeal malignancy. The various types of nasopharyngeal cysts may be differentiated from Tornwaldt's cyst by anatomical site and pathological findings. Marsupialization or complete excision is the preferred treatment with low incidence of recurrence. |
本系統中英文摘要資訊取自各篇刊載內容。