巨大莖突以嗆食表現

Giant Styloid Process Presenting with Choking

林伯鴻(Po-Hong Lin) ； 廖學儒(Hsueh-Lu Liao)

《台灣耳鼻喉頭頸外科雜誌》 39卷6期 (2004/12) Pp. 249-252

https://doi.org/10.6286/2004.39.6.249

摘要

莖突過長或莖突舌骨韌帶鈣化在臨床上常導致病患咽喉痛、顏面痛、頭頸部疼痛。其它一些合併的症狀包括耳痛、喉部異物感等。儘管很多人有莖突過長的情形，但只有少數人會有症狀。2003年3月l名52歲男性病患是以進食嗆食、下頜下區頸部腫塊症狀來本院求診。經過電腦斷層檢查顯示左側頸部腫塊為巨大莖突和莖突舌骨韌帶鈣化圓柱體，長度約7cm，直徑約1.5cm，從顳骨鼓室部延伸至舌骨的小角。經由頸外部分切除術處理，術後追蹤10個月至今，病患症狀獲得明顯改進，無併發症的產生。由於莖突過長引起嗆食的症狀罕見，而病人卻完全無吞嚥疼痛情形，特此提出報告，並就過去的文獻，討論此病的成因、診斷、及處置等。

關鍵字

莖突過長 ； 頸部腫塊 ； 進食嗆食

並列摘要

Elongated styloid process or calcification of stylohyoid ligament frequently results in clinical symptoms, including pain in the pharynx; face, head and neck. It is also associated with otalgia as well as a foreign body sensation in the pharynx. Although an elongation of styloid process is relatively common, only few people suffer from the symptoms described above. A 52-year-old man complaining of a left submandibular neck mass and easy choking when swallowing came to our hospital during March, 2003. A CT scan revealed a left neck mass caused by huge styloid process and cylindrical calcification of stylohyoid ligament, which was measured to be 7cm in length and 1.5cm in diameter. It spanned from the tympanic portion of the temporal bone to the lesser cornu of the hyoid bone. A surgical procedure for partial reduction was performed using an external approach. After a follow-up for 10 months up to the present time, the symptoms have dramatically improved without complications. This is a rare case of choking, instead of odynophagia, caused by elongated styloid process. Hence we present it as a case report and discuss its causes, diagnosis and treatment.

並列關鍵字

elongated styloid process ； neck mass ； choking