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口腔、咽、喉发生脂肪瘤较少见,咽后间隙脂肪瘤更为罕见。作者报告咽后间隙脂肪瘤导致睡眠呼吸暂停综合征1例, 病例介绍 患者,男性,56岁,上呼吸道阻塞、打鼾、频发睡眠呼吸暂停已2年。鼻腔粘膜、鼻甲及鼻中隔均正常,咽后壁偏左发现一质软且无搏动的包块,表面覆以正常粘膜,肿块累及鼻咽下份至会咽部。CT检查显示咽缩肌与颈椎之间有一脂肪密度团块,细针穿吸细胞学检查排除恶性病变。诊断:咽后间隙脂肪瘤。经口作咽部切开摘除肿瘤。肉眼观,瘤体呈多叶状、淡黄色,表面有光泽并有较完整的被膜,体积约为9.5cm×6.0cm×4.0cm;镜下观,为典型脂肪瘤。术后随访,患者打鼾明显减少,多导睡眠图检查证实睡眠呼吸暂停症状消失,白天嗜睡现象亦显著好转。
Oral, pharynx, laryngeal lipoma are rare, lip space lipoma is more rare. The authors report 1 case of sleep apnea syndrome caused by lipoma of the pharyngeal space. The patients were male, 56 years old, with obstruction of the upper respiratory tract, snoring and frequent episodes of sleep apnea 2 years. Nasal mucosa, nasal septum and nasal septum were normal, pharyngeal wall left side found a soft and non-beating mass, the surface covered with normal mucosa, mass involving the nasopharynx to the pharynx. CT examination revealed a fat density between the pharyngeal constrictor and cervical spine mass, fine needle aspiration cytology to rule out malignant lesions. Diagnosis: Posterior pharyngeal lipoma. Oral throat to remove the tumor. The naked eye, the tumor was multi-lobed, yellowish, shiny surface and a more complete film, the volume of about 9.5cm × 6.0cm × 4.0cm; microscopic view of the typical lipoma. Postoperative follow-up, patients significantly reduced snoring, polysomnography confirmed sleep apnea symptoms disappear, daytime drowsiness also significantly improved.