超细电子鼻咽喉镜在诊断婴幼儿咽喉疾病中的应用

The application of thin rhinolarynx electronic videoendoscope in the infants with laryngopharyngeal disease

目的探讨电子鼻咽喉镜在婴幼儿咽喉疾病诊断中的应用价值。方法采用Pentax-1130型超细电子鼻咽喉镜对121例喉喘呜伴有不同程度吸气性呼吸困难或声音嘶哑的婴幼儿（包括新生儿）进行了检查。结果121例患儿中喉软化症66例（54．5％），咽喉部先天性囊肿29例（24．0％），喉乳头状瘤、声带麻痹、声门异物、咽后脓肿分别为7例（5．8％）、6例（5．0％）、5例（4．1％）、3例（2．5％），咽后肿物、喉纤维瘤、声门型喉蹼、下咽异物和气管狭窄各1例（0．8％）。结论121例伴有不同程度吸气性呼吸困难的喉喘鸣患儿中，除喉软化症以外，有近一半（45．5％）的患儿经过电子鼻咽喉镜检查在咽喉部发现了器质性病变。超细电子鼻咽喉镜在诊断婴幼儿及新生儿咽喉疾病中具有很大优势，随诊随查，不必预约，不需要镇静，可在自然呼吸状态下检查，并发症少，图像清晰，结果可靠，在临床上可推广使用。

Objective To investigate the value of thin rhinolarynx electronic videoendoscope in the diagnosis of laryngopharyngeal disease of infants. Methods Pentax-1130 thin rhinolarynx electronic videoendoscope was used to examine 121 infants （ included newborn） under 3 years with laryngeal stridor accompanied with inspiratory dyspnea or hoarse voice. Results Of 121 children, 66 cases were laryngomalacia （54. 5% ）,29 cases were laryngopharyngeal congenital cyst （24. 0% ）,7 cases were laryngeal papilloma （5.8%） ,6 cases were vocal cord paralysis （5.0%） ,5 cases were foreign body in glottis（4. 1% ） ,3 cases were retropharyngeal abscess （ 2. 5 % ）, retropharyngeal mass, fibroma of larynx, glottic laryngeal web, foreign body in hypopharynx and tracheal stenosis were each 1 case（0. 8% ）. Conclusion Among 121 cases with laryngeal stridor accompanied with inspiratory dyspnea except laryngomalacia, nearly half of the cases were found structural disease by using rhinolarynx electronic videoendoscope. Thin rhinolarynx electronic videoendoscope plays predominant role in the diagnosis of laryngopharyngeal disease happened in the infant and newborn. It is easy to follow-up, without requirment of subscription and conscious-sedation. The image is clear and reliabale. The examination can be performed under general breathing, with less complication and could be applicable extensively.