新生儿先天性舌根囊肿的临床特征及治疗效果分析

Analysis of clinical features and treatment outcomes of congenital lingual root cysts in newborns

摘要:

目的 分析新生儿先天性舌根囊肿的临床特征、诊断方法及手术治疗效果。方法 回顾性分析2020年1月—2025年12月河南省儿童医院郑州儿童医院收治的32例先天性舌根囊肿新生儿的临床资料，包括新生儿的围产期情况、临床表现、辅助检查特征、手术方式及其预后情况。结果 32例患儿中，早产儿6例（18.8%），合并宫内窘迫者14例（43.8%）。临床表现呈现不同程度的气道受累：喉喘鸣30例（93.8%），吸气性三凹征19例（59.4%），其中重度呼吸阻塞需气管插管者9例（28.1%）；喂养困难10例（31.3%），其中5例（15.6%）出生10 d后体重仍低于出生体重，提示存在生长迟缓。电子喉镜检查显示，囊肿均位于患儿舌根部，平均最大直径为(13.6± 4.7)mm。32例患儿均在支撑喉镜低温等离子辅助下行舌根肿物切除术，平均手术时间为(35.8±12.9)min。术后气管插管平均时间为(1.22±1.45)d，24h内拔管率65.6%，平均住院时间为(15.7±6.7)d。术后病理均为良性囊肿，其中囊壁为鳞状上皮者25例，囊壁为纤毛柱状上皮者7例。随访至2026年3月，无1例复发，均无严重并发症。结论 新生儿先天性舌根囊肿以不同程度的上气道梗阻为主要表现。辅助检查中电子喉镜联合MRI有助于早期诊断和鉴别诊断。支撑喉镜下低温等离子射频消融术是安全有效的治疗方式。

Abstract:

Objective To analyze the clinical features, diagnostic methods, and surgical outcomes of congenital lingual root cysts in newborns.Methods A retrospective analysis was conducted on the clinical data of 32 newborns with congenital lingual root cysts admitted to Zhengzhou Children’s Hospital, Henan Children’s Hospital from January 2020 to December 2025. Data analyzed included perinatal conditions, clinical manifestations, auxiliary examination findings, surgical approaches, and prognoses.Results Among the 32 neonates, 6 (18.8%) were premature, and 14 (43.8%) had a history of fetal distress. The clinical manifestations showed varying degrees of airway involvement: stridor was observed in 30 cases (93.8%), inspiratory triple retraction in 19 cases (59.4%), and severe respiratory obstruction requiring tracheal intubation in 9 cases (28.1%). Feeding difficulties occurred in 10 cases (31.3%), of which 5 cases (15.6%) had a body weight still below birth weight at 10 days of age, indicating growth retardation. Laryngoscopy revealed that all cysts were located at the base of the tongue, with a mean maximum diameter of (13.6±4.7) mm. All 32 patients underwent endoscopic excision of the laryngeal mass under suspension laryngoscopy assisted by low-temperature plasma technology, with a mean operative time of (35.8±12.9) minutes. The mean postoperative tracheal intubation duration was (1.22±1.45) days, with a 24-hour extubation rate of 65.6%. The mean hospital stay was (15.7±6.7) days. Postoperative pathology confirmed benign cysts in all cases, including squamous epithelium in 25 cases and ciliated columnar epithelium in 7. Follow-up until March 2026 revealed no recurrence and no severe complications.Conclusions Neonatal congenital lingual root cyst primarily presents as varying degrees of upper airway obstruction. Electronic nasolaryngoscopy combined with magnetic resonance imaging facilitates early diagnosis and differential diagnosis. Suspension laryngoscopy-assisted low-temperature plasma radiofrequency ablation is a safe and effective treatment modality.