经口980 nm/1 470 nm双波长光纤激光手术治疗舌根型甲状舌管囊肿的疗效分析

Therapeutic effect of 980 nm/1 470 nm dual-wavelength fiber laser surgery for lingual thyroglossal duct cyst

摘要:

目的 探讨经口980 nm/1 470 nm双波长光纤激光手术切除舌根型甲状舌管囊肿（LTGDC）的临床疗效与安全性。方法 回顾性分析 2017年3月—2023年2月收治的10例 LTGDC 患者的临床资料，均采用支撑喉镜下经口980 nm/1 470 nm双波长光纤激光手术。记录患者性别、年龄、囊肿直径、手术时间、术中出血量、住院时间、术后咽痛评分、并发症及复发情况，术后随访（78.5±29.4）个月。结果 10例均顺利完成手术，其中初发病例8例（80.0%）；复发病例2例（20.0%），均有1次手术史。患者年龄（53.4±12.9）岁，男5例（50.0%），女5例（50.0%）；囊肿直径（20.3±4.8）mm；手术时间（17.8±4.0）min；术中出血量中位数3.5（2.0，5.0）mL；住院时间中位数 2.0（1.0，2.3）d。术后咽痛评分呈显著下降趋势（F=79.5，P<0.001）：咽痛评分术后1 d中位数4.0（3.0， 4.3）分，术后1周中位数2.0（1.8，2.0）分，术后2周中位数0.5（0.0，1.0）分，术后1个月中位数0.0（0.0，0.0）分。术后无出血、复发，无会厌软骨损伤、咽瘘、颈部瘢痕等并发症。结论 经口980 nm/1 470 nm双波长光纤激光治疗 LTGDC 具有手术时间短、出血量少、住院时间短、术后疼痛轻、恢复快、并发症少及复发率低等优势，对复发病例仍有良好疗效，是安全高效的微创术式。

Abstract:

Objective To investigate the clinical efficacy and safety of transoral 980 nm/1 470 nm dual-wavelength fiber laser surgery for the resection of lingual thyroglossal duct cyst (LTGDC).Methods A retrospective analysis was performed on the clinical data of 10 patients with LTGDC who were admitted from March 2017 to February 2023. All patients underwent transoral dual-wavelength fiber laser surgery under suspension laryngoscope. The data recorded included the patients’ gender, age, cyst diameter, operation time, intraoperative blood loss, length of hospital stay, postoperative sore throat score, complications and recurrence. Postoperative follow-up was conducted for (78.5±29.4) months.Results All 10 patients underwent successful surgery, including 8 (80.0%) primary cases and 2 (20.0%) recurrent cases (both with one previous operation). The patient’s age was (53.4±12.9) years old, with 5 males (50.0%) and 5 females (50.0%). The cyst diameter was (20.3±4.8) mm. The operation time was (17.8±4.0) minutes. The median intraoperative blood loss was 3.5 (2.0, 5.0) mL, and the median hospital stay was 2.0 (1.0, 2.3) days. The postoperative sore throat score showed a significant downward trend (F=79.5, P<0.001): median score was 4.0 (3.0, 4.3) at 1 day, 2.0 (1.8, 2.0) at 1 week, 0.5 (0.0, 1.0) at 2 weeks, and 0.0 (0.0, 0.0) at 1 month postoperatively. There were no postoperative complications such as bleeding, recurrence, epiglottic cartilage injury, pharyngeal fistula, neck scar or tracheotomy.Conclusions Transoral 980 nm/1 470 nm dual-wavelength fiber laser surgery for LTGDC has the advantages of short operation time, less bleeding, short hospital stay, mild postoperative pain, rapid recovery, fewer complications and low recurrence rate. It also shows favorable efficacy for recurrent cases and is a safe and efficient minimally invasive procedure.