以声嘶为主诉的幼儿声门别针异物一例

倪坤患儿男,2岁,因声嘶2个月于2012年2月3日就诊.家长诉患儿2个月前玩耍时大声哭闹,之后出现声音嘶哑且逐渐加重,3d后几乎不能发声,当时就诊于当地医院,诊断为"喉气管炎",给予抗感染治疗效果不佳.随后2个月里声嘶间断反复出现,曾几次就诊于外院,均考虑喉部炎症给予抗感染治疗,症状不能完全改善.发病期间无呼吸困难,无吞咽困难.近3d来出现喉部喘鸣音,经外院介绍就诊于我院.门诊给予纤维喉镜及喉部CT及三维重建检查,纤维喉镜检查发现声门处有一性质不明的异物纵形崁顿,限制声带闭合(图1).CT清晰地显示一枚张开的别针样物位于声门以及声门下气道,与食管关系不明.     

右声门旁间隙异物存留15个月一例

患者女，50岁。2003年10月误咽鱼刺，当时自觉咽部刺痛明显，吞咽时加重。曾试图吞咽饭团将鱼刺带入消化道，但未成功，遂前往当地医院。专科医生检查未发现咽喉部有明显异物，嘱服用抗生素，回家观察。数天后咽部刺痛感略缓解，无吞咽困难，无发热、呼吸困难、胸痛和咳嗽等现象，无颈部触痛感，但咽刺痛感仍存在。2004年4月转而就诊于另一家医院，钡餐X线食管造影未见异常，纤维喉镜检查，发现右侧梨状窝外侧壁一红色新生物，拟诊“梨状窝新生物”而行支撑喉镜下右侧梨状窝活检术，病理报告为“肉芽组织”。     

咽部-颈椎旁间隙异物一例

患儿男,10岁.木棍自咽部插入至颈后部皮下致咽部疼痛、异物感,吞咽障碍6 h于2007年5月20日急诊入院.患儿6 h前口含一木棍玩耍时不慎跌倒,木棍自口咽部插入至颈后右侧部皮下,口吐鲜血约5 ml.     

声门异物一例

声门异物一例缪增华患者男，２３岁。１９９３年１０月１０日就餐中不慎误将鱼头部骨片吸入喉内。当即呛咳，吞咽痛，发音时疼痛加重，声音嘶哑，阵发性咳嗽，痰中带血，无呼吸困难。曾行１个月的抗炎治疗症状未见缓解，反而逐渐加重。还到过两家医院诊治并进行胃镜检查，...     

声门旁间隙淋巴管瘤1例

患者,女,31岁。以感冒后声音嘶哑于2005年8月5日就诊。无明显咽喉肿痛和发热。抗炎、地塞米松及庆大霉素雾化吸人治疗半个月,效果不明显,声音嘶哑加重。频闪喉镜检查见右声带表面明显肿胀突出、呈肿块样,表面略发白,稍有不平,肿物从外向内压迫声带并超越中线,声门裂明显变窄,声带运动受限,声门闭合不良。     

咽旁间隙和声门旁间隙感染1例

患者 ,男 30岁。8天前因感冒引起发热 ,伴咽喉痛 ,以左侧为主 ,3天后出现声音嘶哑 ,渐加重 ,出现呼吸困难 ,到当地医院就诊 ,立即行环甲膜切开后转我院。查体 :心、肺、肝、脾无异常。左侧颌下触及肿大淋巴结约 2 cm× 2 cm× 1cm大小 ,压痛明显 ,活动。左侧颈部压痛明显 ,双侧颈部皮下握雪感。颈前环甲膜处带金属气管套管。张口受限 ,咽部粘膜急性充血、水肿 ,左侧扁桃体内移 ,表面无脓栓附着 ,喉部未能检查。CT(外院 ) (图 1,2 )示 :左侧咽旁间隙增厚 ,左侧声门旁间隙增厚。入院后给予气管切开 ,抗生素和激素等治疗 ,病情好转 ,咽喉痛减…     

声门区异物一例

患者男,85岁.因进食虾后呛咳、声音嘶哑1d于2010年4月1日就诊.患者ld前吃虾后出现呛咳,伴声音嘶哑,无明显呼吸困难和咽喉疼痛,立即就诊于当地医院,初步考虑喉部异物,为求进一步治疗转来我院.查体:神清,口腔及下咽部未见异物,行纤维喉镜检查见双侧室带充血,略肿胀,双侧声带充血,声门区前部可见一异物存留,遮盖前连合,初步诊断:声门异物.入院后给予雾化吸入治疗,后于全身麻醉电视支撑喉镜下行声门异物取出术,手术顺利,取出后见异物为一虾头,长约1.5 cm,卡于前连合处,其头部尖刺刺入右侧声带前1/2处黏膜下(图1).术后患者声嘶明显减轻,但未完全消失.经抗炎及雾化吸入治疗3d后出院.患者2个月后复诊声嘶完全消失.     

喉异物并声嘶误诊一例

患者男,59岁,因持续声嘶一月余伴呼吸困难一周于2005年11月入院。患者一月前不慎摔倒,头面部先着地,口唇及颏部撞击在水泥台阶上,口唇裂伤,上下门齿脱落,当即出现声音嘶哑,无明显呼吸困难,无呛咳。当地医院予以清创缝合及抗炎、雾化治疗,声嘶无缓解并逐渐出现咽喉部分泌物增多,     

Vocal cord fixation caused by an impacted fish bone in hypopharynx: report of a rare case

We report a rare case of vocal cord fixation caused by a fish bone in the hypopharynx. The patient was a 72-year-old woman. She presented with hoarseness that had appeared suddenly while eating baked fish. The diagnosis was suggested by a clinical history and confirmed by a computed tomography scan. The fish bone was removed via microlaryngoscopic operation under general anesthesia. The restoration of her vocal cord mobility required a few months. Vocal cord fixation is an extremely rare complication of a pharyngeal foreign body. In all of the few cases reported previously, the fixation was caused by mechanical obstruction of vocal cord movement or by recurrent nerve palsy secondary to inflammation. Our case is not typical of mechanical or inflammatory fixation. It is possible that the recurrent nerve was damaged directly by the fish bone.     

Xanthoma of the temporal bone: a unique case of this rare condition

Xanthoma of the temporal bone is extremely rare; we describe only the fourteenth reported case. Our case is further remarkable because it is the first report of such an occurrence in a patient with familial type III hyperlipoproteinemia. Moreover, while otalgia, infection, hearing loss, and tinnitus were the most common initial symptoms in the previous 13 cases, our patient reported only diplopia, vertigo, and unstable gait. The patient underwent a simple mastoidectomy and debulking, and his diplopia, vertigo, and unstable gait resolved.     

A rare aneurysmal bone cyst of the maxillary sinus: a case report

Aneurysmal bone cyst (ABC) is a non-neoplastic expansile bone lesion that is common in the long bones; only 2% occurs in the head and neck. We present a case of ABC in a 23-year-old male and describe the clinical and radiological features, histopathology and treatment. Magnetic resonance imaging (MRI) demonstrated multiple internal septations, cysts with fluid-fluid levels of varying intensity, and an intact rim of low-intensity signal completely surrounding the lesion. The tumor was removed by enucleation with resection of the lateral nasal cavity. Histopathologic diagnosis was ABC and fibrous dysplasia. We suggest that MRI is very useful for the diagnosis of ABC. ABC is thought to follow other lesions, and thus when treating ABC, it is important to determine whether any pre-existing lesion has preceded or not; in particular, if the lesion site is in the head and neck region.     

A case of migratory fish bone in the thyroid gland

Fish-bone foreign bodies represent a common condition readily identified in the pharynx. We encountered a case of fish bone in the thyroid gland. Only three other such cases have been reported in the English-language literature. This foreign body was identified by computed tomography and ultrasonography 16 days after onset, and removed through a cervical skin incision. The diagnosis and treatment of extrapharyngeal foreign bodies are discussed.