Pu Shilei, Li Wei, Li Xiaoyan
Department of Otolaryngology Head and Neck Surgery，Shanghai Children's Hospital，Shanghai，200062，China.
Department of Otolaryngology，Tangshan Maternal and Child Care Service Centre.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Jun;35(6):517-520;524. doi: 10.13201/j.issn.2096-7993.2021.06.007.
To explore the diagnosis and therapeutic strategy of laryngomalacia associated with tongue base cyst in infants. A retrospective analysis was performed on 36 cases of tongue base cyst including 12 cases with concurrent laryngomalacia. All the cysts of the tongue base were completely resected, and no recurrence occurred during the 6-months follow-up. Twelve patients with laryngomalacia were intubated in the ICU after surgery. Tube detachment occurred in one patient in the 1st day after surgery and no reintubation was performed immediately because of stable breathing and the absence of stridor. However, the stridor occurred again in the 5th day after surgery, and revision surgery was performed 1 month after surgery. One patient still had obvious stridor after extubation in the 5th day after sugery, but the shape of glottis was good by laryngoscopy, the stridor was significantly improved at one-month follow-up. One patient died in the 4th day after the operation. The efficiency of surgical treatment in pediatric patients with tongue base cyst and concurrent laryngomalacia was 83.33%. Laryngomalacia combined with tongue base cyst is not uncommon in clinical practice. The symptoms of tongue base cyst may mask those of the underlying laryngomalacia, since their symptoms are highly similar. Simple resection of tongue base cyst may affect the outcome of treatment. Surgeons should further investigate and identify the presence of laryngomalacia after surgical resection of the tongue base cyst and make corresponding management. For type Ⅲ laryngomalacia that cannot be determined intraoperatively, low-temperature plasma ablation of mucosa in the epiglottic valley may be a more minimally invasive option.
探讨婴儿舌根囊肿合并喉软化症的诊断及治疗策略。对36例舌根囊肿患者进行回顾性分析，其中12例合并喉软化症。所有舌根囊肿均完整切除，术后6个月随访无复发。12例合并喉软化症的患者术后在重症监护病房插管。1例患者术后第1天出现脱管，因呼吸平稳且无喘鸣未立即重新插管。然而，术后第5天再次出现喘鸣，术后1个月行翻修手术。1例患者术后第5天拔管后仍有明显喘鸣，但喉镜检查声门形态良好，1个月随访时喘鸣明显改善。1例患者术后第4天死亡。小儿舌根囊肿合并喉软化症手术治疗有效率为83.33%。喉软化症合并舌根囊肿在临床实践中并不少见。舌根囊肿的症状可能掩盖潜在喉软化症的症状，因为它们的症状非常相似。单纯切除舌根囊肿可能影响治疗效果。外科医生在切除舌根囊肿后应进一步检查并确定是否存在喉软化症，并进行相应处理。对于术中无法确定的Ⅲ型喉软化症，会厌谷黏膜低温等离子体消融可能是一种更微创的选择。
