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舌根部囊腫續發軟喉症—病例報告

Laryngomalacia Secondary to Tongue Base Cyst - Case Report

摘要


目前對軟喉症的診斷以動態變化較重要,只要呼吸的動態變化中喉部有呼吸道陷落,包括會厭陷落,鬆弛且脫垂,或楔形軟骨脫垂等均可視為軟喉症。錄影式喉纖維內視鏡檢查(videofiberolaryngoscopy),可觀察到喉部這些動態變化,作正確診斷。大部分軟喉症是原發性的,但也有少數是其他原因引起此一動態變化而造成繼發性軟喉症。本科於1993年6月經歷1名兩個月大男嬰因為吸氣喘鳴至本院就診,經以喉纖維內視鏡檢查,發現在舌根部有一直徑1.5cm的囊腫,致使在吸氣時壓迫會厭,使會厭往後向喉前庭方向脫垂吸入,呈現軟喉症,而在呼氣時會厭直立,並無呼吸阻塞情形。囊腫經手術切除後,會厭恢復正常,不再有吸氣時脫垂吸入喉部的軟喉情形出現。

並列摘要


Laryngomalacia is a diagnosis based on the dynamic changes of supraglottic structure. This diagnosis is established by observing a flaccid epiglottis which prolapses backward during inspiration, or prolapsing arytenoids. Videofiberolaryngoscopy allows a continuous observation of these dynamic changes and is a valuable tool for making a precise diagnosis. In June 1993, we encountered an infant with inspiratory stridor. Videofiberolaryngoscopy revealed a tongue base cyst. We also recorded a flaccid epiglottis which prolapsed backward during inspiration, but remained in its normal position during expiration. After deroofing the cyst, the patient’s condition improved and the epiglottis stopped prolapsing.

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