新生兒會厭谿部囊腫導致呼吸窘迫－病例報告

Neonatal Vallecular Cyst Induced Airway Obstructions-Case Report

洪子涵(Tzu-Han Hung) ； 謝明芝(Ming-Chih Hsieh) ； 王士豪(Shih-Hao Wang)

《台灣耳鼻喉頭頸外科雜誌》 53卷2期 (2018/06) Pp. 67-71

https://doi.org/10.6286/jtohns.201806_53(2).067

摘要

新生兒先天性喉部囊腫是一種罕見疾病。臨床上多以呼吸道窘迫、餵食困難等症狀表現，嚴重甚至可能上呼吸道阻塞而導致死亡。本研究報告兩個案例，病例一爲2個月大女性新生兒，有反覆咳嗽、活動力較差及喝奶時常有嗆咳等情形至門診求診。喉部纖維内視鏡發現一巨大卵黄色囊腫位於會厭谿部，造成會厭部下蓋壓迫喉部，導致上呼吸道阻塞。經喉顯微二氧化碳雷射切除手術將囊腫完全切除，術後9個月追蹤無復發跡象。病例二則爲19天大男性新生兒，因呼吸困難、進食量減少且餵食後皆有嘔吐情形且活動力下降，而至急診求診。喉内視鏡發現一巨大卵黄色囊腫位於會厭谿部，壓迫會厭軟骨及喉部導致上呼吸道阻塞。接受喉顯微二氧化碳雷射切除手術將囊腫完全切除。術後6個月追蹤無復發現象。回顧文獻，國内外過去有零星個案報告但治療方式上仍有不同選擇，本文兩病例術後恢復良好且追蹤逾半年皆無復發，因此對於新生兒先天性會厭谿部囊腫的治療方式，我們建議喉顯微二氧化碳雷射切除手術將囊腫完全切除是適當的治療方式。

關鍵字

vallecular cyst ； neonate ； CO_2 laser（會厭谿部囊腫 ； 新生兒 ； 二氧化碳雷射）

並列摘要

Neonatal vallecular cyst is a rare disease. The most common clinical presentations including of upper airway obstruction, feeding difficulty and failure to thrive. Furthermore, it may also compromise airway and even cause death. We report two cases of neonatal vallecular cyst. The first case is a two-month-old girl presented with poor activity and easy vomiting, choking when breastfeeding. The laryngoscopy revealed a large cystic mass at vallecula with compression of epiglottis which induced upper airway obstruction. There was no recurrence nine months after the larygomicroscopic surgery with carbon dioxide laser excision of vallecular cyst. The second case is a nineteen-day-old boy, who was admitted from emergency room because of breathing difficulty, feeding difficulty and vomiting after feeding. The laryngoscopy showed one large cystic mass at vallecula with compression of epiglottis and induced upper airway obstruction. The larygomicroscopic surgery with carbon dioxide laser excision of vallecular cyst was performed smoothly. He was followed up for six months and there was no recurrence. There are different treatment modalities from the literature review. Our study demonstrated that two patients treated successfully by laryngomicroscopic surgery with CO_2 laser excision without recurrence after six months of follow up. We suggested that laryngomicroscopic surgery with CO_2 laser excision of cyst is an adequate treatment for neonatal vallecular cyst.

並列關鍵字

vallecular cyst ； neonate ； CO_2 laser