Eldesoky Tarek, Khafagy Yasser, Osman Engy
Pediatric Allergy, Respiratory and Clinical Immunology Unit, Faculty of Medicine, Mansoura University, Egypt.
J Bronchology Interv Pulmonol. 2011 Apr;18(2):188-90. doi: 10.1097/LBR.0b013e3182171602.
We report the case of a 6-year-old boy who presented with a 2-month history of stridor and respiratory difficulty, preceded 1 month earlier by dry cough. The evaluation before admission revealed glottic narrowing due to diffuse inflammatory changes. On examination, the patient was seen to have biphasic stridor and respiratory distress with diminished breath sounds throughout both lung fields. Laryngoscopy revealed multiple polyps and granulation tissue causing marked laryngeal narrowing. No foreign body was detected in the larynx. Elective tracheostomy was performed before proceeding to bronchoscopy. The latter procedure revealed a foreign body in the left main bronchus. One week after the foreign body extraction, repeat bronchoscopy revealed nearly total disappearance of polyps and granulation tissues. The tracheostomy tube was removed and the patient recovered uneventfully. To our knowledge, this is the first reported case of stridor caused by a migrating laryngeal foreign body. A thorough endobronchial examination should be carried out in patients with unexplained laryngeal polyps and granulation tissue.
我们报告了一名6岁男孩的病例，该男孩有2个月的喘鸣和呼吸困难病史，1个月前出现干咳。入院前的评估显示由于弥漫性炎症改变导致声门狭窄。检查时，患者出现双相喘鸣和呼吸窘迫，双肺野呼吸音减弱。喉镜检查发现多个息肉和肉芽组织，导致明显的喉部狭窄。喉部未检测到异物。在进行支气管镜检查之前进行了择期气管切开术。后一项检查发现左主支气管有异物。异物取出一周后，重复支气管镜检查显示息肉和肉芽组织几乎完全消失。气管切开管被拔除，患者顺利康复。据我们所知，这是首例由迁移性喉部异物引起喘鸣的报道病例。对于原因不明的喉部息肉和肉芽组织患者，应进行全面的支气管内检查。
