新生儿先天性咽喉部囊肿治疗方案探讨

Operation mode of congenital laryngeal cysts in newborns

目的探讨新生儿先天性咽喉部囊肿的治疗方案。方法回顾性分析17例新生儿先天性咽喉部囊肿患儿的病例资料。所有患儿术前均行纤维喉镜、颈部触诊、超声、CT或MRI检查确诊为咽喉部囊肿。根据囊肿部位、大小及患儿症状选择不同手术方式,其中2例患者行单纯囊液穿刺抽吸术治疗,3例接受传统囊肿顶盖切除术治疗,12例接受低温等离子射频消融术治疗,术后随访0.5~3.0 a。结果 17例咽喉部囊肿患儿手术过程顺利。2例行单纯囊液穿刺抽吸术的患儿分别于术后第6、10天复发,1例行传统囊肿顶盖切除术的患儿于术后第40天复发,1例行低温等离子射频消融术的患儿于术后5个月复发。所有复发病例(4例)复发后行低温等离子射频消融术,术后再次随访0.5~3.0 a,无复发。结论应根据囊肿的类型选择适当的手术方式。囊壁的完整切除是预防复发的关键。低温等离子射频消融术治疗新生儿先天性咽喉部囊肿具有手术时间短、术中出血少、术后反应轻、复发率低等优点,值得临床推广。

Objective To explore the best operation mode of congenital laryngeal cysts in newborns. Methods The clinical data of 17 newborns with laryngeal cysts were reviewed retrospectively. After the examination of fiber laryngoscope, neck palpa- tion, ultrasound, and imaging（ CT or MRI）, all patients were diagnosed as laryngeal cysts. Operation modes were selected ac- cording to the size and location of cysts, and the patient＇ s symptoms. Surgical managements included 2 cases of simple cyst fluidaspiration, 3 cases of traditional cyst cap resection, 12 cases of low - temperature plasma radiofrequency ablation, and all pa- tients were followed up by 0. 5 to 3.0 years. Results The operations of all of the 17 patients were successful. Both of the 2 ca- ses who were treated with simple cyst fluid aspiration were found recurrence at the sixth and tenth day, 1 of the 3 cases treated with traditional cyst cap resection was found recurrence at the fortieth day, and 1 of the 12 cases treated with low- temperature plasma radiofrequency ablation was found recurrence after 5 months. All recurrences cases （total 4 cases） were treatelow - tem- perature plasma radiofrequency ablation, and no recurrence was found after 0. 5 to 3.0 years follow - up. Conclusion The ap- propriate surgical management should be selected according to the type of cyst. Complete resection of the cyst wall is the key to preventing recurrence. The low - temperature plasma radiofrequency ablation has the advantages of short operation time, less bleeding, little injury, low recurrence rate and light postoperative reaction, and it is worthy of clinical promotion.