気道狭窄のため喉頭摘出を要した喉頭軟骨腫例

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  • A Case of Laryngeal Chondroma with Airway Obstruction That Was Treated by Total Laryngectomy
  • キドウ キョウサク ノ タメ コウトウ テキシュツ オ ヨウシタ コウトウ ナンコツ シュレイ

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<p>Laryngeal chondroma is a rare disease, accounting for less than 1% of all laryngeal primary tumors. Tissue biopsy, CT, and MRI are useful for the diagnosis, but differentiation from chondrosarcoma is often difficult. The primary treatment is surgery. Although chondromas are benign tumors, among cases in which the tumor is left unresected, the recurrence rate is high, and in many cases, depending on the size and location, they may affect the respiratory tract. Therefore, it is necessary to select a treatment approach that would include tumor resection, laryngeal preservation, and airway maintenance. We report a case of laryngeal chondroma with airway obstruction in which we performed a total laryngectomy. </p><p>The patient was a 45-year-old man, in whom hypertrophy of the cricoid cartilage was incidentally detected on CT. The patient was referred to an otolaryngologist, who made the diagnosis of laryngeal chondroma. The only symptom at the first visit was mild dyspnea in the supine position, but more than half of the cricoid cartilage had been replaced by a tumor, and it was difficult to remove it while preserving the larynx. Five months following the first visit, a tracheostomy was performed because of exacerbation of respiratory distress caused by enlargement of the tumor. The patient was kept under follow-up, but after 1 year 4 months, he developed airway obstruction and dysphonia due to further growth of the tumor, and we performed a total laryngectomy. Based on a review of past reports and the course of this case, we consider that early surgery with larynx preservation is desirable if the tumor is resectable at the time of diagnosis. On the other hand, if the tumor is found to be unresectable with preservation of the larynx at the time of diagnosis, follow-up observation with imaging after securing the airway is one of the useful treatment options. In such cases, total laryngectomy may be performed in the event of development of airway obstruction caused by tumor growth.</p>

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