Department of Otorhinolaryngology and Head and Neck Surgery, National University of Malaysia, Malaysia.
J Coll Physicians Surg Pak. 2022 Apr;32(4):S67-S69. doi: 10.29271/jcpsp.2022.Supp1.S67.
Subglottic hemangiomas may be missed on flexible laryngoscopy or even bronchoscopy requiring a contrast-enhanced computed tomography scan to clinch the diagnosis. We report an otherwise healthy three-month baby girl presenting with recurrent upper airway obstruction with a history of multiple admissions requiring intubation and artificial ventilation. An initial contrast-enhanced computed tomography scan was performed when the child was intubated, which showed no airway anomalies. Subsequent flexible laryngoscopy and diagnostic bronchoscopy showed features of laryngomalacia and subglottic edema; hence, an endoscopic laser-assisted supraglottoplasty was performed. Following the surgical intervention, the child had persistent stridor and a repeat contrast-enhanced computed tomography scan clinched a diagnosis of a localised subglottic hemangioma at the age of 7 months. In the presence of an endotracheal tube, airway hemangiomas may be missed on bronchoscopy and contrast-enhanced computed tomography scan. Key Word: Subglottic stenosis, Congenital, Hemangiomas, Computed tomography.
声门下血管瘤在软性喉镜检查甚至支气管镜检查时可能会被遗漏,需要进行增强 CT 扫描以明确诊断。我们报告了一例无其他异常的 3 个月大女婴,反复出现上呼吸道梗阻,有多次入院需要插管和人工通气的病史。当患儿插管时进行了初始增强 CT 扫描,未见气道异常。随后的软性喉镜和诊断性支气管镜检查显示为杓状软骨软化和声门下水肿特征,因此进行了内镜激光辅助会厌成形术。手术干预后,患儿持续存在喘鸣,7 个月时再次进行增强 CT 扫描确诊为局部声门下血管瘤。在存在气管内导管的情况下,支气管镜和增强 CT 扫描可能会漏诊气道血管瘤。关键词:先天性声门下狭窄、血管瘤、计算机断层扫描。