Fang Tuan-Jen, Cheng Ka-Shun, Li Hsueh-Yu
Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Chang Gung Med J. 2002 Apr;25(4):275-8.
An epiglottic cyst causing airway obstruction is rare in an adult. Early definitive diagnosis and management obviate an unnecessary tracheostomy. We report a case of a 64-year-old woman who arrived at our hospital with progressive stridor and foreign body sensation when swallowing for 6 weeks. A hot potato voice and biphasic stridor were remarkable upon physical examination. Indirect mirror and fibroscopic examination revealed a huge epiglottic cyst. The neck lateral X-ray and computed tomography scan demonstrated a huge cystic mass over the epiglottis. A 2.5 x 3.0 cm cystic mass was removed with endoscopic CO2 laser after needle decompression. The patient was discharged on the third day after surgery without complications. An epiglottic cyst in an adult seldom causes upper airway obstruction and is easily ignored by clinicians. We emphasize that complete airway evaluation including routine check-up of the larynx is mandatory for patients with intractable obstructive airway disease. Endoscopic laser surgery is effective in the surgical removal of an epiglottic cyst.
成人会厌囊肿导致气道阻塞的情况较为罕见。早期明确诊断和治疗可避免不必要的气管切开术。我们报告一例64岁女性患者,因进行性喘鸣和吞咽时有异物感6周前来我院就诊。体格检查时,“热土豆声”和双相喘鸣较为明显。间接喉镜和纤维喉镜检查发现一个巨大的会厌囊肿。颈部侧位X线和计算机断层扫描显示会厌上方有一个巨大的囊性肿块。在针吸减压后,通过内镜二氧化碳激光切除了一个2.5×3.0厘米的囊性肿块。患者术后第三天出院,无并发症。成人会厌囊肿很少导致上气道阻塞,临床医生容易忽视。我们强调,对于患有顽固性阻塞性气道疾病的患者,必须进行包括常规喉部检查在内的全面气道评估。内镜激光手术在会厌囊肿的手术切除中是有效的。