- 期刊
以硬式喉直達鏡導引切開引流咽旁膿瘍－二病例報告
Rigid Laryngoscope - Guided Incision and Drainage of a Parapharyngeal Abscess: Report of 2 Cases
摘要
咽喉感染引起咽旁膿瘍(parapharyngeal abscess)的病例，若未儘早發現及處置，併發症及死亡率很高。以往處理方法主要是投予抗生素、合併細針抽吸或外科手術切開引流，但對口咽較低部位的膿瘍，常無法充份清創及引流，本文報告兩例咽旁膿病例，因膿瘍位皆為口嗯較低部位，故嘗試在硬式喉直達鏡導引下予以切開引流膿瘍，術後並輔予抗生素治療，結果，病人症狀迅速緩解，傷口復原良好。所以，咽旁膿瘍倘若靠近口咽較低位置，可能可以嘗試這種手術方法，我們的經驗是，這種手術方法簡單、容易操作、傷口小、恢復快、沒有頸部傷口、沒有併發症，且縮短住院天數，可能是治療口咽較低部位的咽旁膿瘍之另一種方法。
並列摘要
Parapharyngeal abscesses, associated with oropharyngeal infection, have high complication and mortality rates if not recognized and managed early. They are generally managed by 1 of 2 approaches: medical and surgical treatment. Medical treatment comprises antibiotic administration and/or fine-needle aspiration. Surgical treatment comprises incision and drainage (I&D). An abscess in the lower portion of the oropharynx can be complicated by incomplete debridement, drainage, and ventilation, and thus there is a lower success rate. For this reason, 2 cases of acute tonsillitis complicated by parapharyngeal abscess formation underwent rigid laryngoscope-guided I&D followed by adjuvant antibiotic administration. Symptoms were relieved, and recovery was rapid. Accoreing to our experience, I&D guided by a rigid laryngoscope seems to be effective for parapharyngeal abscesses in the lowest portion of the oropharynx: this procedure has the advantages of simplicity, easy manipulation, production of only a small wound, shorter recovery, shorter hospitalization, and no external neck wound.
延伸閱讀
- Lin, J. K. (1990). 咽喉鑽鑿式活組織檢法手術後出血引起急性上呼吸道阻塞－病例報告. Acta Anaesthesiologica Sinica, 28(2), 249-251. https://www.airitilibrary.com/Article/Detail?DocID=P20170519003-199006-201811270001-201811270001-249-251
- Wang, W. S., Chen, P. R., & Yang, M. C. (2016). 經頸部切開引流手術於低位後咽膿腫之適應症與治療成效. 台灣耳鼻喉頭頸外科雜誌, 51(3), 174-179. https://doi.org/10.6286/2016.51.3.174
- 陳信雄、林曜祥、林烱堃（1995）。咽後間隙膿瘍：一病例報告。Journal of Medical Sciences，15(4)，301-308。https://www.airitilibrary.com/Article/Detail?DocID=10114564-199502-201306260002-201306260002-301-308
- Tateda, M., Yokoyama, T., Mizukawa, A., & Sato, H. (2011). Introduction of New Laryngeal Closure Methods for Patients with Intractable Aspiration. Japanese Clinical Medicine, (), 53-55. https://doi.org/10.4137/JCM.S7537
- Kao, S. C., Chiou, H. J., Hsu, J. C., Lin, C. M., & Lui, P. W. (2006). Difficult Oral Endotracheal Intubation in an Acromegalic Patient Receiving Transsphenoidal Surgery-A Case Report. Acta Anaesthesiologica Taiwanica, 44(1), 31-34. https://www.airitilibrary.com/Article/Detail?DocID=02541319-200603-44-1-31-34-a