Hogikyan N D, Bastian R W
Department of Otolaryngology--Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109-0312, USA.
Laryngoscope. 1997 Feb;107(2):260-5. doi: 10.1097/00005537-199702000-00021.
Saccular cysts are uncommon disorders that represent cystic dilatation of the laryngeal saccule. They are distinguished from laryngoceles by their lack of lumenal continuity with the endolarynx, and the fact that they are not air filled. Voice change is the most common clinical presentation in adults, whereas airway compromise is more common in infants. Management recommendations range from observation of asymptomatic lesions, to endoscopic marsupialization or excision, to excision through a laryngotomy or the thyrohyoid membrane. The literature states that large or recurrent saccular cysts require the exposure afforded by a transcervical approach. This report describes complete endoscopic laser excision of large, symptomatic saccular cysts in seven adults. Four of the seven patients were referred with recurrent cysts after the failure of endoscopic marsupialization procedures. None required tracheotomy, and only three of seven were observed overnight in the hospital. Surgical technique with emphasis on complete excision, pre- and postoperative radiographic and surgical anatomy, and treatment outcome are discussed.
囊状囊肿是一种罕见的疾病，表现为喉囊的囊性扩张。它们与喉气囊肿的区别在于与喉内没有管腔连续性，且不是充满空气的。声音改变是成人最常见的临床表现，而气道受压在婴儿中更为常见。治疗建议范围从观察无症状病变，到内镜袋形缝合术或切除术，再到通过喉切开术或甲状舌骨膜进行切除。文献表明，大型或复发性囊状囊肿需要经颈入路提供的暴露。本报告描述了7例成人大型有症状囊状囊肿的完全内镜激光切除术。7例患者中有4例在内镜袋形缝合术失败后出现复发性囊肿。无一例需要气管切开术，7例中只有3例在医院过夜观察。讨论了强调完全切除的手术技术、术前和术后影像学及手术解剖结构以及治疗结果。
