颈侧部喉气囊肿

Laryngocele on the lateral neck

喉气囊肿是由于喉囊的异常扩张或疝出所导致的喉部病变,其发病因素尚不完全清楚,可能与喉囊的先天性发育不良、喉内压升高以及炎症或肿瘤堵塞喉室开口有关。喉气囊肿按发生部位与甲状舌骨膜的关系分为喉内型、喉外型与混合型。喉内型喉气囊肿的主要症状为声嘶、咽部异物感、吞咽困难、喘鸣、不同程度的呼吸困难甚至突然窒息;喉外型与混合型喉气囊肿的临床体征主要表现为颈侧部可压缩性的软组织包块,受感染后形成喉脓囊肿,以及颈部不明原因的反复感染与肿痛。根据体征、触诊、穿刺和影像学检查可对颈部发生的喉气囊肿做出正确诊断,同时应注意与颈部的腮裂囊肿、神经鞘瘤、甲状舌管囊肿、颌下囊肿及颈静脉畸形等软质包块相鉴别。手术切除是治疗喉外型与混合型喉气囊肿的有效方法。

Laryngocele is a rare laryngeal disease due to abnormal dilation or herniation of the laryngeal saccule. The cause of laryngocele is unclear, but it is probably related to congenital dysplasia of the laryngeal saccule, increased intralaryngeal pressure and may be secondary to inflammation or neoplastic lesions that occur around the laryngeal ventricle. Laryngocele is divided into internal, external and mixed type according to its relationship with the thyrohyoid membrane. The main symptoms of the internal type are hoarseness, foreign body sensation in pharynx, dysphagia, stridor, different degrees of difficulty in breathing and even sudden asphyxia. The main clinical manifestations of the external and mixed types present as a compressible soft tissue mass or a repeated infection and painful swelling of unknown causes on the lateral neck if the laryngocele becomes infected to form a pyolaryngocele. The correct diagnosis may be established by the clinical signs, palpation, needle aspiration and radiological imaging. Differential diagnosis of the laryngocele include： branchial cyst, Schwannoma, jugular phlebectasia, thyroglossal duct cyst, and submandibular cyst occurring on the neck. Surgical resection is the effective method for the treatment of the external and combined laryngocele.