Chanin L R, Greenberg L M
Department of Otolaryngology, Children's Hospital of Michigan, Detroit 48201.
Laryngoscope. 1988 Apr;98(4):422-7. doi: 10.1288/00005537-198804000-00014.
Few clinical situations can be as frightening, challenging, and as rewarding as stabilizing the airway of a child. Most causes of pediatric upper airway obstruction are well recognized, often discussed in the literature, and commonly encountered in practice. However, ectopic thyroid (i.e., thyroid tissue found in places other than its normal location) may be an unusual cause of pediatric upper airway obstruction with which the clinician may not be familiar. The resulting airway obstruction may be slow or rapid in onset, total or partial, and the relationship of the thyroid to the airway may be clear or obscure. Two cases of obstructing ectopic thyroid are presented which demonstrate the spectrum within which this form of airway obstruction may occur. One case is the first reported example in the English literature of pediatric intratracheal thyroid. A review of the literature is also presented. Four types of ectopic thyroid (lingual, sublingual, thyroglossal, and intralaryngotracheal) are illustrated and discussed in relation to their effect upon the pediatric upper airway. The authors also review the developmental anatomy of the thyroid and present two major theories regarding the development of intralaryngotracheal thyroid. The possible etiologies of the other ectopic forms are also discussed.
很少有临床情况能像稳定儿童气道那样令人恐惧、充满挑战且收获颇丰。小儿上气道梗阻的大多数病因已广为人知，常在文献中被讨论，且在实践中也很常见。然而，异位甲状腺（即甲状腺组织出现在其正常位置以外的地方）可能是小儿上气道梗阻的一个不常见病因，临床医生对此可能并不熟悉。由此导致的气道梗阻可能起病缓慢或迅速，完全或部分梗阻，甲状腺与气道的关系可能清晰或不明确。本文介绍了两例梗阻性异位甲状腺病例，展示了这种气道梗阻可能出现的范围。其中一例是英文文献中首例报道的小儿气管内甲状腺病例。本文还对相关文献进行了综述。文中阐述并讨论了四种异位甲状腺（舌部、舌下、甲状舌管和喉气管内）及其对小儿上气道的影响。作者还回顾了甲状腺的发育解剖学，并提出了关于喉气管内甲状腺发育的两种主要理论。文中还讨论了其他异位形式的可能病因。
