游离前臂皮瓣治疗瘢痕性咽腔狭窄1例

Reconstruction of scarring pharyngeal stenosis with forearm free flap:a case report

1病例报告患者,男,33岁,因＂反复口腔溃疡10余年,伴憋气、吞咽困难1年,加重1个月＂于2016年11月2日入院。患者10余年前出现反复口腔溃疡,偶有生殖器溃疡,腹部偶有皮疹出现。6年前曾于当地医院诊断为白塞病（Beheet disease,BD）,并行地塞米松静脉点滴治疗,具体剂量不详,疗程3d,2～3次/年,患者自诉效果可;3年前患者出现吸气性呼吸困难,伴吞咽阻挡感、咽痛。

A 33-year-old man presented with recurrent oral ulcers for more than 10 years,accompanying dyspnea and dysphagia for 1 year and aggravate for 1 month.Physical examination：pharyngeal cavity stenosis,mucous retention,epiglottis was extruded into the infant type.Electronic laryngoscope：Epiglottis curl,bilateral pyriform sinus disappeared.Ulcer and scar changes can be seen in the lateral wall of bilateral hypopharynx,piriform sinus and posterior annular area,and cover the throat inlet.Neck CT showed：soft tissue thickening in the posterior wall of oropharynx and laryngopharynx-prevertebral fascia,thickening in the right aryepiglottic fold and with local niche;slight uneven enhancement in enhanced scanning,and disappearance of bilateral pyriform sinus.Bilateral parapharyngeal space is clear,laryngopharyngeal wall is not thick,bilateral vocal cords are not thick,and laryngopharyngeal space is clear.Diagnosis：pharyngeal stenosis（scar？）;Behcet＇s disease.