Ricciardelli E J, Richardson M A
Department of Otolaryngology-Head Neck Surgery, University of Washington, Seattle 98195.
Arch Otolaryngol Head Neck Surg. 1991 May;117(5):546-53. doi: 10.1001/archotol.1991.01870170092021.
Cystic hygromas usually present in infancy or early childhood as compressible masses that may rapidly and intermittently enlarge. While they may arise in any anatomic location, hygromas of the head and neck are especially difficult to manage since enlargement may cause serious sequela such as airway obstruction, feeding difficulties, and speech pathology. Complete extirpation of these lesions is often impossible, and recurrence rates are accordingly high. We reviewed our 10-year experience in treating cervicofacial cystic hygromas. Of 34 patients, 21 had lesions cephalad to the hyoid and 13 had lesions caudal to the hyoid. While none of the 13 children with infrahyoid lesions demonstrated feeding or respiratory difficulties, eight of 21 children with suprahyoid involvement presented with dysphagia or airway compromise. The recurrence rates for infrahyoid and suprahyoid lesions were 15% and 81%, respectively. Those children with suprahyoid hygromas also experienced an increased operative complication rate compared with patients with infrahyoid involvement. Principles of management for suprahyoid and infrahyoid lesions are described, including the specific management of lingual, submandibular, parotid, and parotofacial hygromas.
囊状水瘤通常在婴儿期或幼儿期表现为可压缩的肿块，可能会迅速且间歇性地增大。虽然它们可发生于任何解剖部位，但头颈部的水瘤尤其难以处理，因为其增大可能导致严重的后遗症，如气道阻塞、喂养困难和言语病理学问题。这些病变通常无法完全切除，因此复发率很高。我们回顾了我们治疗颈面部囊状水瘤的10年经验。34例患者中，21例病变位于舌骨上方，13例病变位于舌骨下方。舌骨下方病变的13名儿童均未出现喂养或呼吸困难，而舌骨上方受累的21名儿童中有8名出现吞咽困难或气道受压。舌骨下方和舌骨上方病变的复发率分别为15%和81%。与舌骨下方受累的患者相比，舌骨上方水瘤的儿童手术并发症发生率也更高。本文描述了舌骨上方和舌骨下方病变的处理原则，包括舌部、下颌下、腮腺和腮腺面部水瘤的具体处理方法。
