Walner David L, Parker Noah P, Kim Oliver S, Angeles Ronald M, Stich Duane D
Department of Otolaryngology and Bronchoesophagology, Rush University Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612, USA .
Arch Otolaryngol Head Neck Surg. 2008 Mar;134(3):272-7. doi: 10.1001/archoto.2007.47.
To describe a previously unreported condition of the neonatal larynx.
Case series of 4 neonates with an uncommon laryngeal lesion.
Tertiary care children's hospital.
Four neonates in the first 10 days of life with stridor, hoarseness, and respiratory distress.
The patients were examined using flexible fiberoptic laryngoscopy, and laryngeal lesions were identified and subsequently removed using microlaryngoscopy. Photodocumentation of the lesions was performed. Microscopic evaluation of biopsy specimens by a pathologist followed.
Each patient's medical record was carefully reviewed for prenatal history, birth history, neonatal history, pathologic findings, and office follow-up.
All 4 neonates were delivered atraumatically and developed symptoms of upper airway obstruction within the first few minutes to days of life. Each neonate was found to have an obstructive laryngeal lesion requiring surgical intervention. No child had other congenital abnormalities or a history of obvious laryngeal trauma. Pathologic review of each laryngeal specimen revealed inflammatory lesions with characteristic features of a lobular capillary hemangioma (or a pyogenic granuloma).
The diagnosis of a lobular capillary hemangioma of the larynx should be considered in the differential diagnosis of a newborn with stridor, hoarseness, or respiratory distress. The cases seem to be of congenital origin, although acquired pathogenesis cannot be ruled out. Treatment of these lesions includes microscopic surgical excision.
描述一种此前未报道过的新生儿喉部疾病。
4例患有罕见喉部病变的新生儿病例系列。
三级护理儿童医院。
4例出生后10天内出现喘鸣、声音嘶哑和呼吸窘迫的新生儿。
使用可弯曲纤维喉镜对患者进行检查，识别喉部病变，随后通过显微喉镜手术将其切除。对病变进行拍照记录。随后由病理学家对活检标本进行显微镜评估。
仔细查阅每位患者的病历，了解其产前病史、出生史、新生儿病史、病理检查结果及门诊随访情况。
所有4例新生儿均顺产，在出生后的几分钟至几天内出现上呼吸道梗阻症状。每例新生儿均被发现患有需要手术干预的阻塞性喉部病变。没有患儿有其他先天性异常或明显的喉部外伤史。对每个喉部标本的病理检查显示为炎症性病变，具有小叶状毛细血管瘤（或化脓性肉芽肿）的特征。
对于出现喘鸣、声音嘶哑或呼吸窘迫的新生儿，在鉴别诊断时应考虑喉部小叶状毛细血管瘤的诊断。这些病例似乎为先天性起源，尽管不能排除后天性发病机制。这些病变的治疗方法包括显微手术切除。
