下咽埋藏性异物的临床处理策略

目的总结下咽埋藏性异物的诊治经验及探讨手术径路的选择。方法回顾武汉市第一医院耳鼻咽喉科近6年就诊的12例下咽埋藏性异物患者的临床资料，对患者临床表现、异物种类、异物埋藏部位、取出或手术方式、病情转归等进行总结分析，所有患者随访半年以上。结果12例患者中，6例经口内镜下直接切开取出，或在等离子刀或CO2激光辅助下切开取出；3例行颈侧入路取出；1例电子喉镜下成功取出；1例自行消失；1例未做处理、异物在观察期内包埋机化。结论下咽埋藏性异物的诊断及定位依赖于影像学检查，取出方式取决于异物埋藏的部位，首选经口内镜下取出，必要时行颈侧切开径路。

Analysis of clinical treatment of foreign bodies in the hypopharynx

ObjectiveTo summarize the experience of diagnosis and treatment of foreign bodies in the hypopharynx and to discuss the appropriate surgical approach.MethodsThe study reviewed 12 cases of foreign bodies in the hypopharynx in Department of Otolaryngology, the First Hospital of Wuhan City in the recent 6 years. It was summarized and analyzed for the clinical manifestations, types of foreign bodies, buried sites of foreign bodies, methods of removal or operation, and disease outcomes. All cases were followed up for more than half a year.ResultsAmong the 12 patients, foreign bodies of 6 cases in the hypopharynx were removed directly, or by plasma knife or CO2 laser through endoscopy. The foreign bodies of 3 cases were removed through laterocervical approach. 1 case was successfully treated by electronic laryngoscope. The foreign body of 1 cases spontaneously was disappeared. 1 case of foreign body was buried and organized during the observation period.ConclusionThe diagnosis and localization of foreign bodies in the hypopharynx depended on imaging examination. The surgical approach was determined by the location of buried foreign bodies. Transoral endoscopic approach was the first choice, and if necessary, the laterocervical approach was adopted.