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01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，包括围产期情况、临床表现、辅助检查特征、手术方式及预后情况。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10d后体重仍低于出生体重，提示存在生长迟缓。喉镜检查囊肿均位于舌根，平均最大径13.6±4.7 mm。32例均行支撑喉镜下低温等离子辅助下喉肿物切除术，手术时间35.8±12.9min。术后气管插管时间平均1.22±1.45d，24h内拔管率65.6%，平均住院时间15.7±6.7d。术后病理均为良性囊肿（鳞状上皮25例，纤毛柱状上皮7例）。随访至2025年12月，无一例复发，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。电子鼻咽喉镜联合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 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 collected 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 were present 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 suspension laryngoscopy-assisted low-temperature plasma radiofrequency ablation of the laryngeal mass, 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 (squamous epithelium in 25 cases, ciliated columnar epithelium in 7 cases). Follow-up until December 2025 revealed no recurrence or severe complications in any case. Conclusion Neonatal congenital lingual root cyst primarily presents with varying degrees of upper airway obstruction. Flexible laryngoscopy combined with MRI facilitates early diagnosis and differential diagnosis. Suspension laryngoscopy-assisted low-temperature plasma radiofrequency ablation is a safe and effective treatment modality.