气管切开全麻下无水乙醇栓塞治疗咽喉部静脉畸形20例报道

目的 分析咽喉部静脉畸形的治疗方法和效果。方法 总结我院2011年3月—2015年6月收治的咽喉部静脉畸形患者20例,在气管切开下行咽喉部静脉畸形无水乙醇栓塞治疗。结果 15例患者经2次无水乙醇栓塞后咽喉部静脉畸形萎缩并治愈。5例患者合并Ⅱ、Ⅲ度呼吸道阻塞,颞面、下颌、舌体及口底弥漫性静脉畸形行无水乙醇栓塞后,气道阻塞症状治愈,颌面部青斑褪色,静脉畸形缩小并恢复颌面部正常形态;其中3例合并巨舌,行舌体静脉畸形切除成形术取得成功。咽喉部静脉畸形治愈后随访2年未见复发,治愈率50%,有效率100%。结论 咽喉部静脉畸形应早期治疗,气管切开下行无水乙醇栓塞治疗是治愈咽喉部静脉畸形的有效方法。

Absolute ethanol embolization of pharyngolaryngeal venous malformation after tracheotomy under general anesthesia: a report of 20 cases

PURPOSE: To analyze the treatment method and effect of venous malformations of the pharynx and larynx. METHODS: From March 2011 to June 2015, 20 patients with pharyngolaryngeal venous malformation were treated with ethanol embolization under tracheotomy. RESULTS: Fifteen patients underwent twice absolute ethanol embolization, the lesions were remarkably shrank. Five patients developed secondary and tertiary respiratory obstruction, due to diffuse venous malformations. After absolute ethanol embolization, airway obstruction symptoms were relieved, maxillofacial blemishes faded, venous malformation lesions shrank and nearly returned to normal maxillofacial shape; 3 patients with macroglossia underwent operation after embolization, no recurrence was found after 2 years of follow-up in cases with pharyngolaryngeal venous malformations. The cure rate was 50% and effective rate was 100%. CONCLUSIONS: Ethanol embolization is an effective method for treatment of laryngopharyngeal venous malformations under tracheotomy in selected cases.