Zhang Yamin, Xia Zhongfang
Department of Otolaryngology,Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Feb;39(2):141-146. doi: 10.13201/j.issn.2096-7993.2025.02.009.
Analyze the clinical features in children with pharyngeal neoplasm, and explore the clinical efficacy of low-temperature plasma minimally invasive treatment in children with pharyngeal neoplasm. A total of 46 pediatric cases of pharyngeal neoplasms admitted to the Otolaryngology Department of Wuhan Children's Hospital from January 2016 to December 2023 were included. There were 23 males and 23 females, with admission ages ranging from 5 days to 9 years and 4 months, and a median age of 2 years and 2 months. The clinical manifestations, examinations, treatments, and outcomes were evaluated. Among the 46 pediatric patients, 21 were admitted with throat wheezing, 7 with masses in the oropharynx or head and neck, 5 with dyspnea, 4 with snoring during sleep as the main symptom, 3 with hoarseness, 2 with sore throat, 2 with swallowing discomfort, and 2 with difficulty feeding as the first symptom. Comorbidities included 5 cases of combined laryngomalacia, 4 of snoring, 4 of congenital heart disease, 4 of severe pneumonia, 3 of myocardial damage, 1 of multiple deformities, and 1 after hematopoietic stem cell transplantation. All patients underwent CT or MRI examination, with 26 cases undergoing local ultrasound examination and 39 undergoing electronic laryngoscopy examination. A total of 19 patients were transferred to the ICU after surgery, all of whom were patients with pharyngeal cysts. All patients underwent low-temperature plasma minimally invasive surgery, and all patients were diagnosed through pathological examination, including 1 case of nasopharyngeal teratoma, 5 of pharyngeal non-Hodgkin's lymphoma, 1 of oropharyngeal rhabdomyosarcoma, 1 of laryngeal perivascular epithelioid cell tumor (PEComa), and 38 of pharyngeal cysts (2 cases of uvula, 2 of oropharynx, 7 of epiglottic valley, 19 of tongue base, 2 of branchial cleft cyst, and 6 of throat). Pharyngeal neoplasms in children are prone to upper airway obstruction, including some rare or malignant tumors. Imaging and pathological diagnosis can assist in early diagnosis. Depending on the nature of the tumor, early detection and treatment can improve the quality of life and survival rate of children. Low-temperature plasma radiofrequency ablation is safe, minimally invasive, precise, and provides a clear field of vision, making it a valuable treatment option for children with pharyngeal neoplasms.
分析咽肿瘤患儿的临床特征,探讨低温等离子体微创治疗小儿咽肿瘤的临床疗效。纳入2016年1月至2023年12月在武汉市儿童医院耳鼻咽喉科收治的46例小儿咽肿瘤病例。其中男性23例,女性23例,入院年龄5天至9岁4个月,中位年龄2岁2个月。对临床表现、检查、治疗及预后进行评估。46例患儿中,以咽喉部喘鸣入院21例,口咽或头颈部肿物7例,呼吸困难5例,以睡眠打鼾为主要症状4例,声音嘶哑3例,咽痛2例,吞咽不适2例,以喂养困难为首发症状2例。合并症包括先天性喉软化症5例、打鼾4例、先天性心脏病4例、重症肺炎4例、心肌损害3例、多发畸形1例、造血干细胞移植术后1例。所有患者均行CT或MRI检查,26例行局部超声检查,39例行电子喉镜检查。术后共有19例患者转入ICU,均为咽囊肿患者。所有患者均行低温等离子体微创手术,所有患者均经病理检查确诊,其中鼻咽畸胎瘤1例,咽非霍奇金淋巴瘤5例,口咽横纹肌肉瘤1例,喉血管周上皮样细胞瘤(PEComa)1例,咽囊肿38例(悬雍垂2例,口咽2例,会厌谷7例,舌根19例,鳃裂囊肿2例,咽喉6例)。小儿咽肿瘤易导致上呼吸道梗阻,包括一些罕见或恶性肿瘤。影像学及病理诊断有助于早期诊断。根据肿瘤性质,早期发现并治疗可提高患儿生活质量及生存率。低温等离子体射频消融术安全、微创、精准,视野清晰,是小儿咽肿瘤有价值的治疗选择。