会厌谷区囊肿的诊疗策略

Diagnostic and therapeutic strategies for cysts in the vallecular region

摘要:

目的 探讨会厌谷区囊肿鉴别诊断的临床思路，总结会厌谷区囊肿微创手术治疗的方法及其预后情况，以丰富对此类病变的诊疗经验。方法 回顾性分析北京协和医院2019年1月—2023年12月收治的会厌谷区囊肿患者41例，其中男22例，女19例；年龄3~80岁，平均年龄(48.6±18.5)岁。收集患者的临床资料，包括一般资料、症状、诊断方法、麻醉方式、手术方法、病理检查结果及预后。结果 41例患者中，28例为会厌囊肿，5例为舌根囊肿，8例为舌甲状舌管囊肿(LTGDC)。所有手术均经支撑喉镜或FK开口器、在内镜辅助下使用低温等离子刀完整切除会厌谷区囊肿，手术均顺利完成，手术时间平均0.8 h。术后平均住院2.1 d，术后无出血、呼吸困难等并发症，远期随访平均2.6年，未见复发病例。结论 在FK开口器及内镜系统提供良好术野及操作空间的基础上，经口低温等离子刀辅助会厌谷区囊肿切除是一种安全、有效、微创的手术方式。

Abstract:

Objective To explore the clinical thinking to differentiate vallecular region cysts, summarize the methods and prognosis of minimally invasive surgery for these cysts, so as to enrich the experience in the diagnosis and treatment of such lesions. Methods A retrospective analysis was conducted on the clinical data of 41 patients with cysts in the vallecular region admitted to Peking Union Medical College Hospital from January 2019 to December 2023, there were 22 males and 19 females. Their ages ranged from 3 to 80 years old, with an average age of (48.6±18.5) years. Including general information, symptoms, diagnostic methods, anesthesia methods, surgical techniques, pathological results, and prognosis. Results Among the 41 patients, 28 cases were diagnosed as epiglottic cyst, 5 cases as cyst at the base of tongue, and 8 cases as lingual thyroglossal duct cyst (LTGDC). All surgeries were successfully performed using a suspension laryngoscope or an FK retractor, assisted by endoscopy, and completed with coblation. The average operation time was 0.8 hours. Postoperative hospitalization averaged 2.1 days, without postoperative complications such as bleeding or breathing difficulties. The average follow-up period was 2.6 years, and no recurrence was observed. Conclusion With optimal surgical visualization and operating space provided by the FK retractor and the endoscopic system, transoral coblation-assisted resection of cysts in the vallecular region is a safe, effective, and minimally invasive surgical method.