Nuyens Michel R, Bhatti Nasir I, Flint Paul
Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Md. 21287-0910, USA.
ORL J Otorhinolaryngol Relat Spec. 2004;66(6):341-4. doi: 10.1159/000081892.
To evaluate the clinical, radiological presentation and surgical management of fibrovascular polyps of the hypopharynx.
Retrospective medical analysis of a case report. We report the case of a 66-year-old man, who presented with an incarcerated left inguinal hernia, vomiting and regurgitation of a large mass into the oral cavity resulting in syncope. MRI and cine-esophagram demonstrated a large mass in the cervical esophagus. At the time of herniorrhaphy, endoscopy revealed an 11.8-cm hypopharyngeal mass that completely obstructed the oropharynx.
The airway was secured by tracheostomy and the lesion was subsequently removed via open pharyngotomy. Postoperatively, a second polyp was found ball-valving into the airway, and an endoscopic resection was performed prior to decannulation. Histopathology of both lesions confirmed the diagnosis of a fibrovascular polyp.
Fibrovascular polyps are rare benign intraluminal esophageal lesions resulting in mild symptoms of dysphagia that may also cause significant morbidity such as syncope and asphyxia. This is the first report of synchronous fibrovascular polyps of the hypopharynx.
评估下咽纤维血管性息肉的临床、影像学表现及外科治疗方法。
对一份病例报告进行回顾性医学分析。我们报告了一名66岁男性的病例，该患者出现左侧腹股沟疝嵌顿、呕吐，大量肿物反流至口腔导致晕厥。磁共振成像（MRI）和食管电影造影显示颈段食管有一巨大肿物。在行疝修补术时，内镜检查发现一个11.8厘米的下咽肿物，完全阻塞口咽。
通过气管切开术确保气道安全，随后经开放性咽切开术切除病变。术后，发现另一个息肉呈活瓣样阻塞气道，在拔管前进行了内镜切除。两个病变的组织病理学检查均确诊为纤维血管性息肉。
纤维血管性息肉是罕见的食管腔内良性病变，可导致轻度吞咽困难症状，也可能引起严重并发症，如晕厥和窒息。这是关于下咽同步性纤维血管性息肉的首例报告。
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