Ruff M E, Oakes W J, Fisher S R, Spock A
Pediatrics. 1987 Aug;80(2):231-4.
A previously healthy 13-year-old boy without myelodysplasia who had mild scoliosis was seen with complaints of nasal congestion, noisy nighttime breathing, and difficulty sleeping. Flattening of the inspiratory loop on the flow-volume curve was found on pulmonary function testing, suggesting a variable extrathoracic obstruction due to a laryngeal lesion. Bilateral abductor vocal cord paralysis and sleep apnea developed precipitously following general anesthesia. Further workup demonstrated a type-I Chiari malformation with syringomyelia. Brainstem abnormalities such as Chiari malformation with secondary tenth cranial nerve deficits should be considered in previously healthy children and adolescents with signs and symptoms of upper airway obstruction and apnea.
一名既往健康、无骨髓发育异常的13岁男孩，有轻度脊柱侧弯，因鼻塞、夜间呼吸嘈杂和睡眠困难前来就诊。肺功能测试发现流量-容积曲线上吸气环变平，提示因喉部病变导致可变的胸外梗阻。全身麻醉后突然出现双侧声带外展麻痹和睡眠呼吸暂停。进一步检查显示为I型Chiari畸形伴脊髓空洞症。对于有上气道梗阻和呼吸暂停体征和症状的既往健康儿童和青少年，应考虑脑干异常，如Chiari畸形伴继发性第十颅神经缺陷。
