婴儿鼻咽部错构瘤的临床诊疗分析

Analysis of clinical diagnosis and treatment of nasopharyngeal hamartoma in infant

目的探讨罕见的婴儿鼻咽部错构瘤的临床诊断思维、治疗方法,降低误诊几率。方法对18例婴儿鼻咽部错构瘤的就诊、误诊、检查、治疗、愈后进行回顾分析。结果 18例患儿年龄均小于3月,均出生即出现反复喉鸣,就诊过程中均被多次误诊为先天性喉软骨发育不良。经详细口腔、口咽检查及纤维鼻咽喉镜检才诊断为鼻咽部新生物,手术切除新生物,病检确诊为错构瘤。结论婴儿期鼻咽部错构瘤罕见,临床表现与幼儿及成人的鼻腔、鼻咽部错构瘤不同。对于出生即有喉鸣、气促的患儿,除了考虑喉部疾病,还应该考虑来自鼻咽部的肿块,应该重视常规的口腔、口咽检查,并进行纤维喉镜检查,CT检查可进一步定位肿块起源,不能凭经验主观臆断而造成罕见的鼻咽部错构瘤的误诊。错构瘤并不是真性肿瘤,手术完整切除肿物是其治疗原则,愈后良好。

Objective To describe the clinical diagnosis and treatment of the nasopharyngeal hamartoma in infant, and reduce the misdiagnosis rate. Methods Retrospective analysis of the diagnosis, misdiagnosis, examinations, treatment and prognosis on 18 patients with nasopharyngeal hamartoma was done. Results 18 patients were within 3 month old and born with stridor, and were misdiagnosed as congenital laryngomalacia. Diagnosis of nasopharyngeal tumor was made after examination and fibrolarynogoscope check, underwent surgical resection, and by pathological results. Conclusions infant nasopharyngeal hamartoma is rare, and clinical manifestation is different from preschool period children and adults. For those who born with strider and be short of breath, we should consider nasopharyngeal tumor besides laryngeal diseases, value examination in the mouth, oropharynx and fibrolarynogoscope check. CT scan can determine the origin of tumor. We cannot just diagnose disease according to experience or it may result to misdiagnosis. Hamartoma are not carcinoma, and the therapeutic principles are operation and general prognosis is good.