veoexrmpzt
Dołączył: 21 Lut 2011
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 Wysłany: Pią 13:51, 11 Mar 2011 Temat postu: mbt scarpe psn syg bzht dkz |
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,[link widoczny dla zalogowanych]
Microwave treatment of laryngeal hemangioma
ryngealneoplasms); hemangioma, cavernous (Hemangioma, cavernous); diagnosis (Diagnosis) 1 male patient clinical data, 51 years old. 40 years for persistent hoarseness, progressive increase 4 years, occasionally sputum with bloodshot eyes, half admitted to hospital with shortness of breath. No dysphagia, no sore throat. 7-35 years in the paint, no tobacco and alcohol habits, family history was normal. Physical examination: calm period when inspiratory dyspnea, mild throat Ming, three depressions sign, not supine. Throat and friction sound friction exist in a sense, the right than the left posterior margin of the thyroid cartilage full. And the screen laryngeal fiberoptic endoscopy, the tumor showed diffuse purple nodules, located in the laryngeal vestibule, bilateral room with the right vocal cord and hose room, move involving the laryngeal surface of epiglottis, the tongue to the right side of the epiglottis side extension, involving the right back outside and right aryepiglottic fold Ministry scoop, scoop the right nodular hemangiomas, diameter 2cm, pedicle, with the upper and lower respiratory activity, cover laryngeal inlet (Figure 1, Annex 3) . Scoop block between the area of submucosal nodules protruding into the trachea and extending down the posterior wall of the first ring. Left vocal cord and can glimpse, activity is good, clear congestion. CT showed the epiglottis to room with valley of soft tissue shadow to the right side for the heavy, the bilateral pyriform sinus shallow, narrow vestibule laryngeal, thyroid cartilage and arytenoid cartilage absorption, airway stenosis. Enhanced arterial phase demonstrated no enhancement, in vein of mild heterogeneous enhancement (Figure 2 Annex 3). Enhanced three-dimensional MRI showed no abnormal throat area vein and artery imaging, throat area that may be cavernous hemangioma. Diagnosis of laryngeal hemangioma, laryngeal obstruction Ⅲ 'degrees. The next day tracheotomy with local anesthesia in the first 3 to 4 tracheal rings at the stoma. No tracheal hemangioma here for economic reasons, do not further DSA and MRI. 2 Discussion of adult laryngeal hemangioma is rare, usually associated with hypopharynx lesions, males, often changing tone and difficulty in swallowing, not associated with skin lesions. Seikaly ~ t summary l0 infants treatment of subglottic hemangioma experience,[link widoczny dla zalogowanych], that small hemangioma (total lumen 6o%) first tracheotomy, and then graded CO laser excision. Bailey reviewed the current infant feeding and other types of treatment of subglottic hemangioma methods proposed: ① small hemangiomas may not need treatment or available CO laser vaporization: ② medium-sized hemangiomas with intralesional steroids for injection and nasal airway insertion Tube: ③ the best choice for a large incision hemangiomas,[link widoczny dla zalogowanych], submucosal resection; ④ giant hemangioma, particularly those around the infringement or MRI, to extend down to the trachea and / or violations of the trachea through the air around the wall organizers, the tracheotomy, waiting for spontaneous regression. Wu Shanshan turn reports such as laryngeal hemangioma 1N 18-year-old male, due to foreign body sensation in the throat,[link widoczny dla zalogowanych], a sense of obstruction 1 year treatment, no hoarseness, but the high tone, the sound quality was floating sensation. Examination showed the epiglottis on the left tongue, throat face, throat vestibular, bilateral pyriform, arytenoid, vocal and chamber with a bulging mass were observed in dark purple mucosal surface, the surface blood vessels expand, the boundary is unclear, the glottis can not be completely peep and. Thyroglossal laryngeal split plus periosteal incision,[link widoczny dla zalogowanych], complete removal of tumor blood vessels to maintain mucosal integrity as far as possible, the laryngeal mucosa of the bits forming joint cooperation. The 3 cases of hypopharyngeal surgery also Hemangioma, that is the majority of hemangioma, surgical resection is the most effective and reliable, especially in multi-site, and exposure to bad diffuse hemangiomas. In case of bleeding, infection and other complications should be surgical, if not total removal, but also supplemented by other methods. Report of the United States and other Lomeo COz laser ablation of the suspended laryngoscope treatment of 4 cases of adult laryngeal hemangioma that the adult laryngeal hemangioma should first be removed under direct laryngoscopy, the available CO laser or Nd-YAG laser. Severe cases, complete obstruction of the airway is usually required tracheotomy, or a large hemangioma involving the deep structure of those jets, only split laryngeal surgery indications. This case report of adult laryngeal hemangioma is rare to be huge, has caused I Ⅱ degrees. Laryngeal obstruction and has violated the deep structure of the larynx, causing a large absorption of the thyroid cartilage and involving the hoses. We expect that a simple surgery or laser treatment is very difficult, graded DSA embolization surgery is feasible in theory, but they are costly and the risk of serious complications, the patient failed to accept. We report the case of the accumulation of clinical data aims to explore the treatment options.
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