摘要
巨舌症乃一罕見而可能導致上呼吸道阻塞之疾病。本病例為一85歲長期臥床之女性慢性住院病患，於會診耳鼻喉科前10日，突然舌頭不斷腫脹，有長約5cm，被迫伸出口腔外，牙齒、牙齦及嘴唇因此遭受壓迫，疼痛不堪。牙齦受到壓擠而流血發炎，牙齒在壓力下而鬆動，舌頭也因此而潰瘍、流血。兩側顳頜關節因無法閉口疼痛不已，造成頭痛。患者因其慢性疾病，已有氣切管而不致有上呼吸道阻塞之情形。病患於全身麻醉下接受舌部切片檢查，病理報告為疑似類澱粉沉積症。接下來數日，由於內科治療不彰，舌頭持續有腫大的情形，長至口外約10cm，患者選擇接受舌頭切除術。切除約110g的舌頭，並拔除8顆受損的牙齒。術後病理報告為舌增生性筋膜炎。病患術後恢復良好，術後追蹤一年亦無再發現象。此病例罕見，故提出此病例報告。
並列摘要
Macroglossia is a rare disease which may lead to upper airway obstruction. In March 2005, our department was consulted to evaluate an inpatient case of an 85-year-old female patient who had presented with sudden onset of tongue protrusion and swelling 10 days prior consultation. Over the course of the 10 days, the patient's tongue had protruded 5cm in length beyond her lips pushing against her teeth and gums. The pressure exerted by the tongue caused tremendous pain, ulcer, oral cavity bleeding, temporal mandibular joint pain, and headache. Some teeth were also dislodged. The patient had previously received a tracheotomy for chronic disease, and therefore did not require emergent management of the upper airway obstruction posed by the hypertrophic tongue. Under general anesthesia, the patient underwent a biopsy of her tongue lesion. The pathologic report suggested amyloidosis. Despite conservative medical treatment, the patient's tongue continued to grow in size and protruded to 10 cm beyond her lips. Eventually, the patient elected for surgical debulking of the tongue mass. Approximately 110g of tongue was removed by subtotal glossectomy, together with eight damaged teeth. The final pathologic results led to the diagnosis of tongue proliferative fasciitis. The post-operative care was uneventful. There has been no recurrence after 1 year of follow-up.
延伸閱讀
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