持续声嘶婴儿117例病因分析

目的 探讨婴儿持续声嘶的病因.方法 回顾性分析2008年6月至2010年7月间因持续声嘶就诊的婴儿117例(所有患儿均经2周抗炎治疗后声嘶无好转).按初诊年龄分为3组:新生儿组22例,小于6个月龄组60例,小于12个月龄组35例.所有患儿均接受电子喉镜检查,部分患儿行CT、心脏彩超、病理检查,并结合病史分析病因.结果 117例患儿中声带肥厚增生45例次(37.81%),声带麻痹39例次(32.78%),喉血管瘤7例次(5.89%),喉蹼喉囊肿4例次(3.36%),声带息肉2例次(1.68%),声门闭合不全2例次(1.68%),喉乳头状瘤、声带肉芽增生(气管插管后)、颈部淋巴管瘤压迫声门各1例次(各占0.84%);喉镜检查发现占位性病变但未进一步检查确诊者4例,喉镜检查没有发现异常13例.39例声带麻痹患儿伴发先天性心脏病者共19例,占48.72%.年龄越小声带麻痹患儿比率越高,其中新生儿组达50.00%,小于6个月龄组36.67%,小于12个月龄组17.14%,差异有统计学意义(x2=7.18,P＜0.05).结论 引起婴儿持续声嘶的病因以声带肥厚增生最多见,其次为声带麻痹.声带麻痹在小龄婴儿中较大龄婴儿更常见,以先天性心脏病术后及先天性心脏病为主要原因.

Abstract：

Objective To explore the causes of persistent hoarseness in infants. Methods One hundred and seventeen infants with persistent hoarseness treated in the department of otorhinolaryngology in Children's Hospital of Fudan University between June 2008 and July 2010 were retrospectively analyzed ( all patients received antibiotic therapy for 2 weeks and the symptoms were not relieved after that). The patients were divided into three groups according to the age at first visit: 22 newborns, ＜ 6 months old in 60 cases,＜ 12 months old in 35 cases. All patients had video laryngoscope examinations. Some of them received CT scan, cardiac ultrasonography and pathological examination in additional. The diagnosis was established by clinical history and imaging modalities, and the causes were analyzed subsequently. Results Among the 117 patients, 45 cases were vocal hypertrophy and hyperplasia (37. 81% ), 39 cases were vocal cord paralyses (32. 78% ), 7 cases were laryngeal hemangiomas (5. 89% ), 4 cases were laryngeal webs and cyst (3. 36% ), 2 cases were vocal cord polyps ( 1.68% ), 2 cases were glottic incompetences ( 1.68% ),1 case was laryngeal papillomas(0. 84% ), 1 case was vocal code granulomas (0. 84% ), 1 case was glottis restricted by neck lymphangioma (0.84%); 4 cases were undetermined and 13 cases were no abnormalities. The percentage of patients with congenital heart diseases (19 cases)in vocal cord paralysis was 48. 72%. The proportion of vocal cord paralysis in younger group was higher than that in elder one ,their percentage were 50. 00%, 36. 67% and 17. 14% respectively ( x2 = 7. 18, P ＜ 0. 05). Conclusions A variety of causes can lead to persistent hoarseness in infants. The majority of them are vocal hypertrophy and hyperplasia, followed by vocal cord paralyse. Vocal cord paralysis is more common in younger infants than in elder ones, and the main causes are post-cardiac surgery and congenital heart disease.

Analysis of the causes of 117 infants with persistent hoarseness

Objective To explore the causes of persistent hoarseness in infants. Methods One hundred and seventeen infants with persistent hoarseness treated in the department of otorhinolaryngology in Children's Hospital of Fudan University between June 2008 and July 2010 were retrospectively analyzed ( all patients received antibiotic therapy for 2 weeks and the symptoms were not relieved after that). The patients were divided into three groups according to the age at first visit: 22 newborns, ＜ 6 months old in 60 cases,＜ 12 months old in 35 cases. All patients had video laryngoscope examinations. Some of them received CT scan, cardiac ultrasonography and pathological examination in additional. The diagnosis was established by clinical history and imaging modalities, and the causes were analyzed subsequently. Results Among the 117 patients, 45 cases were vocal hypertrophy and hyperplasia (37. 81% ), 39 cases were vocal cord paralyses (32. 78% ), 7 cases were laryngeal hemangiomas (5. 89% ), 4 cases were laryngeal webs and cyst (3. 36% ), 2 cases were vocal cord polyps ( 1.68% ), 2 cases were glottic incompetences ( 1.68% ),1 case was laryngeal papillomas(0. 84% ), 1 case was vocal code granulomas (0. 84% ), 1 case was glottis restricted by neck lymphangioma (0.84%); 4 cases were undetermined and 13 cases were no abnormalities. The percentage of patients with congenital heart diseases (19 cases)in vocal cord paralysis was 48. 72%. The proportion of vocal cord paralysis in younger group was higher than that in elder one ,their percentage were 50. 00%, 36. 67% and 17. 14% respectively ( x2 = 7. 18, P ＜ 0. 05). Conclusions A variety of causes can lead to persistent hoarseness in infants. The majority of them are vocal hypertrophy and hyperplasia, followed by vocal cord paralyse. Vocal cord paralysis is more common in younger infants than in elder ones, and the main causes are post-cardiac surgery and congenital heart disease.