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成人咽旁孤立性肌纤维瘤致气道梗阻

Solitary myofibroma of the oropharynx causing airway obstruction in an adult.

作者信息

Lin Harrison W, Jung David, Lee Linda N, Sadow Peter M, Rocco James W

机构信息

Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, 101 The City Drive South, Bldg. 56, Suite 500, Orange, CA 92868, USA.

出版信息

Ear Nose Throat J. 2014 Sep;93(9):410-7.

Abstract

Myofibromas are benign neoplasms believed to be the most common fibrous proliferation of childhood. We present an unusual case of a 44-year-old woman who developed acute airway obstruction from a myofibroma in the oropharynx and accordingly required emergent tracheotomy tube placement. Serial laser excisions to adequately remove the entire lesion while maintaining pharyngeal structure and function were performed, and the patient was successfully decannulated. To date she has remained free of signs and symptoms of recurrence. Although rare in adults, solitary myofibromas should be considered in the differential diagnosis of any subcutaneous or submucosal head and neck lesion. Moreover, clinicians treating adult and pediatric patients with known solitary or multicentric forms of myofibroma should be aware of its potential for airway obstruction. Patients found to have a pharyngeal myofibroma should be managed with airway stabilization, surgical excision with preservation of speech and swallow function, and close postoperative monitoring for recurrence.

摘要

肌纤维瘤是一种良性肿瘤,被认为是儿童期最常见的纤维增生性病变。我们报告了一例罕见病例,一名44岁女性因口咽部肌纤维瘤导致急性气道梗阻,因此需要紧急放置气管切开套管。我们进行了一系列激光切除术,在保持咽部结构和功能的同时充分切除整个病变,患者成功拔管。迄今为止,她没有复发的迹象和症状。虽然肌纤维瘤在成人中罕见,但在任何皮下或粘膜下的头颈部病变的鉴别诊断中都应考虑到孤立性肌纤维瘤。此外,治疗已知患有孤立性或多中心性肌纤维瘤的成人和儿童患者的临床医生应意识到其导致气道梗阻的可能性。发现患有咽部肌纤维瘤的患者应进行气道稳定处理,在保留言语和吞咽功能的情况下进行手术切除,并在术后密切监测复发情况。

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