婴儿喉囊肿的临床治疗策略  

The management of infantile laryngeal cysts

作　　者：娄凡[1] 明澄 高燕[1] 祖金艳 马静[1] LOU Fan;MING Cheng;GAO Yan;ZU Jinyan;MA Jing(Department of Otolaryngology Head and Neck Surgery,Kunming Children's Hospital,Kunming,650228,China)

机构地区：[1]昆明市儿童医院(昆明医科大学附属儿童医院)耳鼻咽喉头颈外科,昆明650228

出　　处：《临床耳鼻咽喉头颈外科杂志》2025年第2期120-123,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨婴儿喉囊肿的治疗策略。方法:回顾性分析2020年1月-2023年1月在昆明市儿童医院诊治的19例喉囊肿患儿的临床资料。所有患儿均经电子喉镜检查后确诊。19例患者中,12例新生儿收住新生儿重症监护病房,其中5例因重度呼吸困难术前已行气管插管机械通气治疗,7例予头罩吸氧治疗;其余7例患儿收治耳鼻咽喉头颈外科,其中3例因睡眠中频繁憋气,予睡眠时面罩吸氧治疗。所有患儿均在全身麻醉下采取低温等离子射频消融术的手术方式切除肿物。结果:术后3例新生儿因合并肺炎未拔除气管插管,其余患儿在麻醉完全清醒后顺利拔管,且未放置胃管。所有患儿术后呼吸困难均消失,且未出现出血、声嘶、喉狭窄并发症。5例患儿术后1个月喉鸣症状未完全缓解,经电子喉镜检查诊断为喉软化症,建议定期随访。1例患儿于术后4个月复发,接受二次手术,随访半年未再复发。结论:内镜下低温等离子射频消融术是治疗喉囊肿的有效手术方式,术后复发率低。喉囊肿可合并喉软化症,这可能是患儿术后症状不缓解的原因。Objective To explore the therapeutic strategy for laryngeal cysts in infants.Methods A retrospective analysis of the clinical data of 19 children with laryngeal cysts treated in Kunming Children's Hospital from January 2020 to January 2023.All patients were diagnosed through electronic laryngoscopy examination.Twelve neonates were admitted to the neonatal intensive care unit.Five of them received mechanical ventilation with tracheal intubation before surgery due to severe respiratory distress,and seven received oxygen therapy with a head mask.The remaining seven children were admitted to Department of Otolaryngology Head and Neck Surgery,of which three cases were treated with oxygen therapy through a mask during sleep due to frequent shortness of breath during sleep.All patients underwent low-temperature plasma radiofrequency ablation under general anesthesia to remove the cysts.Results Three newborns were unable to have their tracheal tubes removed due to complications with pneumonia after surgery,while the rest of the children were able to have their tubes successfully removed after complete anesthesia,and no gastric tubes were placed.All postoperative respiratory difficulties in the children disappeared,and there were no complications such as bleeding,hoarseness,or laryngeal stenosis.Five pediatric patients had incomplete relief of laryngeal ringing symptoms one month after surgery,and electronic laryngoscopy diagnosed laryngeal softening.Regular follow-up is recommended.One child relapsed 4 months after surgery and underwent a follow-up surgery six months later without recurrence.Conclusion Endoscopic low-temperature plasma radiofrequency ablation is an effective surgical method for treating laryngeal cysts,with a low postoperative recurrence rate.Laryngeal cysts may be accompanied by laryngeal softening,which may be a possible reason for the postoperative symptoms not improving.

关 键 词：喉囊肿 婴儿 手术治疗 

分 类 号：R767[医药卫生—耳鼻咽喉科]