喉部杓狀軟骨瘤

發生於頭頸部的軟骨瘤實屬少見，而位於喉部杓狀軟骨處的軟骨瘤更是罕見。本部於2005年1月經歷1名74歲女性，主訴爲漸進性呼吸困難將近4個多月，併有明顯吸氣時喘鳴，因症狀持續加劇及出現吞嚥易嗆而轉診至本院求診，經內視鏡檢查發現有一巨大腫瘤佔據喉部左側杓狀軟骨位置，並壓迫到對側聲帶引起呼吸道阻塞，因此安排患者接受氣管切開手術以建立呼吸道並實行硬式喉鏡切片檢查，經影像學及病理檢查證實爲源自喉部杓狀軟骨處之軟骨瘤。後續依據腫瘤位置採取硬式喉鏡經口咽直達喉部的方式，施行杓狀軟骨及軟骨瘤切除手術，術後呼吸功能恢復情況良好並保留住喉部發聲機能，也可正常吞嚥進食。喉部軟骨瘤因腫瘤生長緩慢，症狀進展並不明顯，往往不易早期診斷，最後常因腫瘤壓迫呼吸道或因喉追神經及環－杓狀軟骨關節侵犯導致聲帶麻痺才被診斷，喉部軟骨瘤也有機會轉變成惡性軟骨肉瘤的潛能。此外，喉部杓狀軟骨瘤生長位置常導致困難插管，需施行氣管切開手術以建立呼吸道，亦增加疾病治療的危險性，因病例罕見故特此提出報告。

關鍵字

軟骨瘤；軟骨肉瘤；杓狀軟骨

並列摘要

Cartilaginous tumors of the larynx are rare and are usually slow-growing. We report here a case of a 74 y/o housewife with a history of Parkinson's disease, who was admitted after suffering from inspiratory stridor and dyspnea for 4 months. The patient's symptoms included stridor, dyspnea, slurred speech, hoarseness, easy choking and dysphagia. Laryngoscopy revealed a huge laryngeal mass on the left side of the arytenoid cartilage and compression of the opposite vocal cord, which had compromised her airway. The patient underwent an emergency tracheostomy, and when the biopsy was investigated, it revealed chondroma. Arytenoidectomy and excision of the chondroma was subsequently performed. After discharge, the patient attended regular follow-up appointments at an out-patient clinic and showed no further signs of hoarseness or dyspnea. Cartilaginous tumors are more common in men and incidence peaks during the 6th and 7th decades of life. Malignant progression is evident in about 7% of case. Tracheostomy placement at the time of biopsy may be necessary and whether this is necessary depends on the size, location, and firmness of the tumor.

並列關鍵字

chondroma ； chondrosarcoma ； arytenoid cartilage

國際替代計量

喉部杓狀軟骨瘤

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