喉部囊腫之臨床表現及治療

Clinical Presentation and Management of Laryngeal Cysts

張紘䪸(Hung-Min Chang) ； 李佳茹(Chia-Ru Li) ； 蔡青劭(Stella Chin-Shaw Tsai)

《台灣耳鼻喉頭頸外科雜誌》 51卷1期 (2016/03) Pp. 35-40

https://doi.org/10.6286/2016.51.1.35

摘要

背景：喉部囊腫為少見的良性囊腫，只佔所有良性喉部囊瘤的4.3%至6%。研究分析喉部囊腫個案，可更瞭解喉部囊腫，提供臨床參考。方法：本研究收集了2009年07月31日至2013年12月31日止，童綜合醫療社團法人童綜合醫院確診之喉部囊腫個案。以回溯病歷方式針對症狀、手術方式、囊腫發生部位、囊腫大小、病理報告、有無復發等進行分析。結果：喉部囊腫共68例，幾乎先以喉纖維內視鏡檢查再經切片確診。此報告中喉囊腫女性多於男性，平均年齡為52.8歲。最常見的症狀是喉嚨異物感(69.1%)。上皮囊腫及扁桃囊腫分別為52和16例。位於會厭有37例、杓會厭皺折8例、聲帶7例、喉谿部16例。本研究聲帶囊腫是使用顯微喉鏡冷鋼器械手術為主，而其他喉部囊腫以顯微喉鏡手術下以二氧化碳雷射切除，平均住院時間為2天。復發1例，但再次手術後已無復發。另有1例，術後併發急性肺水腫。結論：喉部囊腫常為上皮囊腫，而喉谿部常為扁桃囊腫。使用顯微喉鏡併二氧化碳雷射手術切除囊腫，手術時間短，住院天數少，併發症少預後良好。雖然喉部囊腫診斷與治療並不困難，但仍需臨床醫師多加留意。

關鍵字

喉部囊腫 ； 喉纖維內視鏡

並列摘要

BACKGROUND: Laryngeal cysts are uncommon benign lesions, comprising only 4.3 to 6% of all benign cysts of the larynx. Case analysis of laryngeal cysts may provide important information for the treatment. SUBJECTS AND METHOD: Cases were retrieved from 2009 to 2013 at the Tungs' Taichung MetroHarbor Hospital. Symptoms, surgical method, size and location of cysts, pathology, and the outcome were analyzed. RESULTS: Most of 68 laryngeal cysts cases were confirmed by fiberoptic laryngoscopy. More females had laryngeal cysts than males and their mean age was 52.8 years. The most common symptom was globus sensation (69.1%). Epithelial and tonsillar cysts were found for 52 and 16 cases, respectively. Thirty-seven cysts were located in the epiglottis; eight, aryepiglottic fold; seven, vocal cord, and sixteen, vallecula. Surgical excision for vocal cord cyst was performed by microlaryngoscopy with cold steel and other cysts with carbon dioxide laser. The average hospital stay was 2 days. One recurrent case was successfuly treated and the other case had acute pulmonary edema after the surgery. CONCLUSIONS: Laryngeal cysts were commonly found as epithelial cysts, whereas vallecular cysts were tonsillar cysts. Surgical excision by microlaryngoscopy with carbon dioxide laser or with cold steel was an effective treatment for laryngeal cysts. This procedure had a short surgical time and hospital stay, few postoperative complications and good prognosis. Although the diagnosis and treatment of the laryngeal cysts is not difficult, clinicians needed to treat the disease carefully.

並列關鍵字

laryngeal cyst ； fiberoptic laryngoscope