经口舌根型甲舌囊肿 980nm/1470nm 双波长光纤激光手术疗效分析

Efficacy of 980nm/1470nm dual-wavelength fiber laser for lingual thyroglossal duct cysts

摘要:

目的 探讨经口980nm/1470nm双波长光纤激光手术治疗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 患者临床资料，均采用支撑喉镜下经口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（15.6±4.8）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次术前手术史）。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（3.5±1.6）ml，中位数4.0（2.0，5.0）ml；住院时间（1.9±1.0）d，中位数 2.0（1.0，2.0）d。术后咽痛评分呈显著下降趋势（F=136.82，P<0.001）：术后1天（3.7±0.9）分，术后1周（1.9±0.6）分，术后2周（0.5±0.5）分，术后1月（0.1±0.3）分。术后无出血、无复发，无会厌软骨损伤、咽瘘、颈部瘢痕及气管切开等并发症。结论 经口980nm/1470nm双波长光纤激光治疗 LTGDC 具有手术时间短、出血少、住院时间短、术后疼痛轻、恢复快、并发症及复发率低等优势，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 980nm/1470nm dual-wavelength fiber laser surgery in the treatment of lingual thyroglossal duct cyst (LTGDC) based on real clinical cases. Methods A retrospective analysis was performed on the clinical data of 10 patients with LTGDC admitted from March 2017 to February 2023. All patients underwent transoral dual-wavelength fiber laser surgery under suspension laryngoscope. Gender, age, cyst diameter, operation time, intraoperative blood loss, length of hospital stay, postoperative sore throat score, complications and recurrence were recorded. The mean follow-up time was (15.6±4.8) months. Results All 10 patients successfully underwent surgery, including 8 primary cases (80.0%) and 2 recurrent cases (20.0%, each with 1 previous operation). The mean age was (53.4±12.9) years, with 5 males (50.0%) and 5 females (50.0%). The mean cyst diameter was (20.3±4.8) mm; mean operation time (17.8±4.0) min; mean intraoperative blood loss (3.5±1.6) ml, median 4.0 (2.0, 5.0) ml; mean hospital stay (1.9±1.0) d, median 2.0 (1.0, 2.0) d. Postoperative sore throat score decreased significantly (F=136.82, P<0.001): (3.7±0.9) points at 1 day, (1.9±0.6) points at 1 week, (0.5±0.5) points at 2 weeks, and (0.1±0.3) points at 1 month after operation. There was no postoperative bleeding, recurrence, epiglottic cartilage injury, pharyngeal fistula, neck scar or tracheotomy. Conclusion Transoral 980nm/1470nm dual-wavelength fiber laser surgery for LTGDC has the advantages of short operation time, less bleeding, short hospital stay, mild postoperative pain, rapid recovery, low complication and recurrence rates. It also shows favorable efficacy for recurrent cases and is a safe and effective minimally invasive procedure.