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1例白塞病所致咽狭窄经口视频喉镜手术治疗

A Case of Pharyngeal Stenosis Caused by Behçet's Disease Treated With Transoral Videolaryngoscopic Surgery.

作者信息

Suekata Yu, Hosokawa Kiyohito, Kawasaki Takahiro, Nakatsubo Daisuke, Tanida Masashi, Ogawa Makoto, Inohara Hidenori

机构信息

Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, JPN.

Respiratory Medicine and Clinical Immunology,, Osaka University Graduate School of Medicine, Osaka, JPN.

出版信息

Cureus. 2023 Jan 10;15(1):e33616. doi: 10.7759/cureus.33616. eCollection 2023 Jan.

Abstract

Behçet's disease is a refractory inflammatory disease characterized by recurrent oral aphthous ulcers. Ulcers are commonly seen in the oral cavity and the pharyngeal region. In patients with recurrent pharyngeal ulcers, pharyngeal stenosis may occur and leads to dysphagia. Herein, we report a case of pharyngeal stenosis caused by recurrent ulcers due to incomplete Behçet's disease. Prednisolone, colchicine, and infliximab were administered and resolved the pharyngeal ulcers, however, dysphagia persisted. To improve the swallowing function, a pharyngeal dilation surgery and transoral videolaryngoscopic surgery were performed, which resulted in an enlarged pharyngeal cavity. Oral intake of water was initiated the day after surgery, and after six days, the patient was able to take a normal diet. The pharyngeal stenosis had not recurred for one year after the surgery, and a normal diet continued without any dietary restrictions. Therefore, in a case of a severe oropharyngeal lesion, periodic follow-up and surgical interventions by an otolaryngologist are necessary.

摘要

白塞病是一种以复发性口腔溃疡为特征的难治性炎症性疾病。溃疡常见于口腔和咽部区域。在复发性咽部溃疡患者中,可能会发生咽部狭窄并导致吞咽困难。在此,我们报告一例不完全性白塞病导致复发性溃疡引起的咽部狭窄病例。给予泼尼松龙、秋水仙碱和英夫利昔单抗后,咽部溃疡得到缓解,但吞咽困难持续存在。为改善吞咽功能,进行了咽部扩张手术和经口视频喉镜手术,术后咽部腔隙扩大。术后第二天开始经口进水,六天后患者能够正常饮食。术后一年咽部狭窄未复发,患者继续正常饮食且无任何饮食限制。因此,对于严重的口咽病变病例,耳鼻喉科医生进行定期随访和手术干预是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c55/9911262/8262f6e2328e/cureus-0015-00000033616-i01.jpg

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