鎮静下喉頭内視鏡検査が有用であった乳幼児輪状後部静脈叢隆起例

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タイトル別名
  • A Case of Postcricoid Cushion in Infant Diagnosed with Laryngoscopy Under Sedation
  • チンセイ カ コウトウ ナイシキョウ ケンサ ガ ユウヨウ デ アッタ ニュウヨウジ リンジョウ コウブ ジョウミャクソウリュウキレイ

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<p>Postcricoid vascular abnormalities are rare causes of chronic dysphagia and dyspnea in infants and children. A postcricoid cushion is a mass that becomes obvious when children cry because of venous flux dilation in the postcricoid lesion. The condition can present as a sucking or respiratory disorder, attributable to laryngeal stenosis caused by venous pressure imparted by the mass. The epidemiology and pathophysiology of a postcricoid cushion are poorly known; many cases are asymptomatic and many are often diagnosed as hemangiomas or vascular malformations. Herein, we report a case of an infant in whom postcricoid cushion was diagnosed by laryngoscopy under sedation, considering the unique pressure-dependent characteristics of the lesion.</p><p>A 9-month-old female presented with intermittent stridor associated only with crying. Flexible laryngoscopy revealed a spherical bluish mass in the postcricoid area. Magnetic resonance imaging did not reveal the mass, so that no definitive diagnosis could be made. As we suspected the presence of a pressure-dependent vascular mass (a postcricoid cushion), we performed flexible laryngoscopy with the child under sedation. The lesion was difficult to visualize. We made the diagnosis of postcricoid cushion and followed the patient for 2 years by only serial laryngoscopies. The mass became smaller over time.</p><p>Postcricoid cushion in an infant was diagnosed by laryngoscopy under sedation. It is important to be aware of this unique condition when examining the upper aerodigestive tract. No treatment for postcricoid cushion is needed in the majority of cases, as most patients can be safely observed.</p>

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