鼻咽部脂肪瘤致睡眠呼吸暂停1例报道  

A nasalpharyngeal Lipoma with an initial symptom of obstructive sleep apnea

作　　者：张钦鑫 蒋冬晖 史雅文[1] 吴虹 刘树森 殷敏[1] ZHANG Qinxin;JIANG Donghui;SHI Yawen;WU Hong;LIU Shusen;YIN Min(Department of Otorhinolaryngology,the First Affiliated Hospital,Nanjing Medical University,nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科,南京210029 [2]江苏宜兴市人民医院耳鼻咽喉科 [3]南京仁品耳鼻喉科医院

出　　处：《中国中西医结合耳鼻咽喉科杂志》2024年第3期226-228,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：上呼吸道任何部位的狭窄都可以引起睡眠呼吸暂停,而鼻咽部的狭窄往往因位置隐蔽在常规查体中不易发现。鼻咽部脂肪瘤较为罕见,早期缺乏特异性症状。本文报道一例以睡眠呼吸暂停发病的鼻咽部脂肪瘤。患者男性,23岁,因睡眠呼吸暂停于当地医院就诊,行扁桃体切除术后症状略有好转。3年后打鼾、憋气明显加重,至我院就诊,电子鼻咽喉镜检查提示鼻咽部占位,CT示不规则形脂肪密度肿块影,其内密度欠均匀,MR示左侧鼻咽部见高T1高T2信号肿块,T2抑脂无信号肿物,大小约26mm×38mm。患者经软腭径路完整切除肿瘤,病理为脂肪瘤。术后打鼾、憋气症状消失。本例提示鼻咽脂肪瘤也可导致睡眠呼吸暂停,全面的上呼吸道阻塞部位检查是睡眠呼吸暂停诊疗的重要环节。Sleep apnea can be caused by narrowing of any location of the upper airway,and the problem in the nasopharynx is often difficult to detected by regular physical examination.Nasopharyngeal lipoma is rare and lacks specific symptoms in early stage.We reported a case of nasopharyngeal lipoma with initial symptom of sleep apnea.A 23-year-old man was diagnosed as sleep apnea due to tonsil hypertrophy in the local hospital.His symptoms improved after tonsillectomy and became significantly aggravated 3 years later.We conducted nasopharyngoscopy found nasopharyngeal occupational diease,CT showed irregular fat density mass with uneven internal density and MR showed left nasopharyngeal mass with high T1 and high T2 signal,T2 lipostatic mass without signal,with a size of about 26×38mm.The tumor was completely resected through the soft palate,and the pathological diagnosis was lipoma.The symptoms of snoring and suffocation disappeared after surgery.It is suggested that the nasopharyngeal lipoma could also cause sleep apnea and comprehensive examination of upper respiratory tract obstruction is an important link in sleep apnea diagnosis and treatment.

关 键 词：上呼吸道阻塞 鼻咽部 睡眠呼吸暂停 脂肪瘤 位置隐蔽 特异性症状 脂肪密度 打鼾 

分 类 号：R766[医药卫生—耳鼻咽喉科] R739.63[医药卫生—临床医学]