α-氰基丙烯酸酯正丁酯局部栓塞治疗咽喉部海绵状血管瘤

Application of local injection of n-butylcyanoacrylate for laryngopharyngeal sponge angioma

目的探讨应用α-氰基丙烯酸酯正丁酯(n-butyl-cyanoacrylate,NBCA)注射治疗咽喉部海绵状血管瘤的方法。方法回顾分析了1994年1月～2005年1月收治的19例咽喉部海绵状血管瘤的治疗及预后。19例咽喉部弥漫性海绵状血管瘤的发病无明显性别差异,患者年龄18～67岁,平均40.2岁,19例患者中, 13例为初治患者,6例为治疗后未愈或无效病例;15例单纯采用新型组织黏合剂NBCA注射后切除方法;4例患者进行了以手术切除联合使用NBCA注射治疗,治疗后随访1～7年。结果治愈16例,治愈率84.2% (16/19),好转3例,占15.7%(3/19),残留的表浅肿瘤经YAG激光治疗后痊愈。结论咽喉部海绵状血管瘤少见,无自然消退的趋势,无固定治疗方案可循,新型组织黏合剂NBCA局部注射栓塞或联合使用手术、激光等综合治疗可取得良好效果。

OBJECTIVE To explore the application of n-butyl-cyanoacrylate to treat taryngopharyngeal sponge angioma. METHODS The therapy and outcome of 19 cases of laryngopharyngeal cavernous hemangiomas during 1994.1-2005.1 were analyzed retrospectively. The age of all the patients ranged from 18 to 67 years with an average of 40.2 years. 15 of the 19 cases were sclerotherapied by injection of a new type of tissue adhesive NBCA. 4 of the 19 cases were undergone dissection of the lesion by surgical approach combined with local injection of NBCA. The duration of Follow-up ranged from 1 to 7 years. RESULTS Complete remove of tumor was achieved in 16 cases （84.2%） ; the tumor of 3 cases （15.7%） was removed incompletely, whose residual tumor was ablated by YAG laser in outpatient. CONCLUSION The cavernous hemangioma occures rarely in laryngopharyngx and usually are poorly defined. It is difficult for treatment because of dangerous bleeding and airway obstruction. In this study, CT, MR and DSA were used to define the extent of disease, and a high cure rate were achieved by NBCA injection combined with surgery and laser ablation.