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[下咽纤维血管息肉的诊治经验]

[Experience of diagnosis and treatment of fibrovascular polyp of the hypopharynx].

作者信息

Li Lijie, Tian Xiufen

机构信息

Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 May;35(5):432-435. doi: 10.13201/j.issn.2096-7993.2021.05.011.

Abstract

To explore and analyze the imaging examinations, clinical presentation, operative methods complication and the surgical outcomes of fibrovascular polyp of the hypopharynx (hFVP). The clinical data of 10 patients with hFVP were analyzed retrospectively from January 2015 to June 2020 at the First Affiliated Hospital of Zhengzhou University. All the 10 cases were sporadic. The locations of pedicle: 5 cases were found in pyriform sinus (4 on the left side, 1 on the right side) ,3 cases were found in lateral pharyngeal wall (on the right side),and 2 cases were found in postcricoid space. Among 10 cases, 8 cases were treated with endoscopic coblation cauterization,1 case had excision of endoscopic laryngeal forcep, and 1 case for endoscopic CO2 laser treatment as well as coblation cauterization. Follow up for 5.9-71.4 (30.9) months showed that 7 cases had no recurrence, 2 cases had no connection, 1 cases had recurrence once. One patient recurred once underwent the last operation with transcervical approach as well as tracheotomy,and no recurrence was found in the follow up of 13.2 months. Fibrovascular polyp of the hypopharynx is rare benign submucosal neoplasm clinically, and endoscopic coblation cauterization is a good choice. Recurrent fibrovascular polyp of the hypopharynx can be treated by endoscopic coblation cauterization again, so that patients with multiple recurrences whose polyps are giant or euangiotic can consider the transcervical approach, if necessary, the tracheotomy will also be given.

摘要

探讨并分析下咽纤维血管性息肉(hFVP)的影像学检查、临床表现、手术方法、并发症及手术效果。回顾性分析2015年1月至2020年6月郑州大学第一附属医院收治的10例hFVP患者的临床资料。10例均为散发性。息肉蒂部位置:5例位于梨状窝(左侧4例,右侧1例),3例位于咽侧壁(右侧),2例位于环状软骨后间隙。10例中,8例行内镜下等离子消融烧灼治疗,1例行内镜下喉钳切除术,1例行内镜下CO₂激光治疗及等离子消融烧灼术。随访5.9 - 71.4(30.9)个月,7例无复发,2例无粘连,1例复发1次。1例复发患者最后行经颈入路手术及气管切开术,随访13.2个月无复发。下咽纤维血管性息肉临床上是一种少见的良性黏膜下肿瘤,内镜下等离子消融烧灼是较好的选择。复发性下咽纤维血管性息肉可再次行内镜下等离子消融烧灼治疗,对于息肉巨大或血管丰富且多次复发的患者,必要时可考虑经颈入路手术,同时可考虑气管切开术。

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