新生儿及婴幼儿先天性喉囊肿的临床特点及诊治探讨

目的：对62例新生儿及婴幼儿先天性喉囊肿的诊治进行分析,探讨不同术式的特点。方法：回顾性分析62例新生儿及婴幼儿先天性喉囊肿患儿的资料。经完善颈部触诊、喉镜检查以及CT或MRI等相关术前检查后,所有患儿均在全身麻醉下行喉囊肿切除术。根据分类选择手术术式,1例混合型患儿行颈外进路囊肿摘除术;61例喉内型患儿中,12例行传统咬除囊壁术,12例行动力切削系统切除术,37例行低温等离子射频消融术。结果：62例喉囊肿患儿手术顺利,随访0.5~7.0年无复发。结论：对儿童先天性喉囊肿进行分类分析后选择合适的手术方式,可避免不必要的开放式手术进路,阻止囊肿复发和重复的内镜治疗或气管切开术。低温等离子射频消融术治疗儿童喉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。

The clinical characters and surgical managements of congenital laryngeal cysts in infants

Objective：To classify congenital laryngeal cysts in 62 newborn or infants, and to discuss the characteristics of different operation mode. Method：The clinical data of 62 infants with laryngeal cysts treated were reviewed retrospectively. After the examination of neck palpation, laryngoscope and imaging （CT or MRI）,all patients were under general anesthesia of laryngeal cyst excision, we select operation mode according to the classification. Classification include： 61 cases of cysts were confined to the larynx, 1 case was beyond the larynx. Surgi- cal managements include： an excision through external carotid approach in 1 case beyond the larynx, 61 cases had endoscopic excision under general anesthesia （12 cases with traditional bite exception, 12 cases with powered system and 37 cases with low-temperature radiofrequency ablation）. Result：The operations was successful. No recurrence was found after 0.5 to 7 years follow-up. Conclusion： To chose surgical management after classification and preoperative assessment, which could avoid unnecessary opening surgical approaches, reducing the recurrence, and preventing repeated endoscopic treatment or tracheotomy. The low-temperature radiofrequency ablation had the advantages of short operation time, less bleeding, little injury, low recurrence rate and light postoperative reaction. It is worthy of clinical promotion.