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在杂交手术室中使用泡沫聚多卡醇经口进行荧光镜和内镜引导下硬化治疗口咽喉静脉畸形:病例系列

Fluoroscopy- and Endoscopy-Guided Transoral Sclerotherapy Using Foamed Polidocanol for Oropharyngolaryngeal Venous Malformations in a Hybrid Operation Room: A Case Series.

作者信息

Ishikawa Kosuke, Maeda Taku, Funayama Emi, Murao Naoki, Miura Takahiro, Sasaki Yuki, Seo Dongkyung, Mitamura Shintaro, Oide Shunichi, Yamamoto Yuhei, Sasaki Satoru

机构信息

Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.

Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan.

出版信息

J Clin Med. 2024 Apr 18;13(8):2369. doi: 10.3390/jcm13082369.

Abstract

Treatment of oropharyngolaryngeal venous malformations (VMs) remains challenging. This study evaluated the effectiveness and safety of fluoroscopy- and endoscopy-guided transoral sclerotherapy for oropharyngolaryngeal VMs in a hybrid operation room (OR). Patients with oropharyngolaryngeal VMs who underwent transoral sclerotherapy in a hybrid OR were enrolled. Fourteen patients (six females, eight males; median age of 26 years; range, 4-71 years) were analyzed. The symptoms observed were breathing difficulties (n = 3), snoring (n = 2), sleep apnea (n = 1), and swallowing difficulties (n = 1). Lesions were extensive in the face and neck (n = 9) and limited in the oropharyngolarynx (n = 5). A permanent tracheostomy was performed on two patients, while a temporary tracheostomy was performed on five patients. The treated regions were the soft palate (n = 8), pharynx (n = 7), base of the tongue (n = 4), and epiglottis (n = 1). The median number of sclerotherapy sessions was 2.5 (range, 1-9). The median follow-up duration was 81 months (range, 6-141). Treatment outcomes were graded as excellent (n = 2), good (n = 7), or fair (n = 5). The post-treatment complication was bleeding (n = 1), resulting in an urgent tracheostomy. Fluoroscopy- and endoscopy-guided transoral sclerotherapy in a hybrid OR can be effective and safe for oropharyngolaryngeal VMs.

摘要

口咽喉静脉畸形(VMs)的治疗仍然具有挑战性。本研究评估了在杂交手术室(OR)中,在荧光透视和内镜引导下经口硬化治疗口咽喉VMs的有效性和安全性。纳入在杂交OR中接受经口硬化治疗的口咽喉VMs患者。分析了14例患者(6例女性,8例男性;中位年龄26岁;范围4 - 71岁)。观察到的症状有呼吸困难(n = 3)、打鼾(n = 2)、睡眠呼吸暂停(n = 1)和吞咽困难(n = 1)。病变在面颈部广泛(n = 9),在口咽喉局限(n = 5)。2例患者行永久性气管切开术,5例患者行临时性气管切开术。治疗部位为软腭(n = 8)、咽部(n = 7)、舌根(n = 4)和会厌(n = 1)。硬化治疗的中位次数为2.5次(范围1 - 9次)。中位随访时间为81个月(范围6 - 141个月)。治疗结果分为优(n = 2)、良(n = 7)或中(n = 5)。治疗后并发症为出血(n = 1),导致紧急气管切开术。在杂交OR中,荧光透视和内镜引导下经口硬化治疗口咽喉VMs可能有效且安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6fd/11050875/99dc27724e72/jcm-13-02369-g002.jpg

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