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摘要: 目的 探讨下咽纤维血管性息肉的影像学检查、临床表现、手术方式、并发症及术后疗效。方法 回顾性分析2015年1月-2020年6月经郑州大学第一附属医院收治, 通过手术确认的10例下咽纤维血管性息肉患者的临床资料。结果 10例下咽纤维血管性息肉均为单发。息肉根蒂位置: 梨状窝5例(左侧4例, 右侧1例), 咽侧壁(右)3例, 环后区2例。8例行内镜下低温等离子切除术, 1例行内镜下喉钳切除术, 1例行内镜下CO2激光加低温等离子切除术。共随访5.9~71.4(30.9)个月。7例未复发, 2例失访, 1例复发1次。1例复发1次患者末次手术行颈侧入路切除+气管切开术, 术后随访13.2个月未见复发。结论 下咽纤维血管性息肉是临床罕见的良性黏膜下肿瘤, 内镜下低温等离子切除术是比较好的手术方式, 复发者可再次行内镜下低温等离子切除术, 多次复发且息肉巨大或根蒂血管丰富的患者可考虑经颈侧入路切除术, 必要时辅助气管切开术。Abstract: Objective To explore and analyze the imaging examinations, clinical presentation, operative methods complication and the surgical outcomes of fibrovascular polyp of the hypopharynx (hFVP).Methods The clinical data of 10 patients with hFVP were analyzed retrospectively from January 2015 to June 2020 at the First Affiliated Hospital of Zhengzhou University.Results All the 10 cases were sporadic. The locations of pedicle: 5 cases were found in pyriform sinus (4 on the left side, 1 on the right side), 3 cases were found in lateral pharyngeal wall (on the right side), and 2 cases were found in postcricoid space. Among 10 cases, 8 cases were treated with endoscopic coblation cauterization, 1 case had excision of endoscopic laryngeal forcep, and 1 case for endoscopic CO2 laser treatment as well as coblation cauterization. Follow up for 5.9-71.4(30.9) months showed that 7 cases had no recurrence, 2 cases had no connection, 1 cases had recurrence once. One patient recurred once underwent the last operation with transcervical approach as well as tracheotomy, and no recurrence was found in the follow up of 13.2 months.Conclusion Fibrovascular polyp of the hypopharynx is rare benign submucosal neoplasm clinically, and endoscopic coblation cauterization is a good choice. Recurrent fibrovascular polyp of the hypopharynx can be treated by endoscopic coblation cauterization again, so that patients with multiple recurrences whose polyps are giant or euangiotic can consider the transcervical approach, if necessary, the tracheotomy will also be given.
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