Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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협착음과 수유시 청색증 및 성장 장애를 보인선천성 후두개 낭종(vallecular cyst) 1예

A case of congenital vallecular cyst associated with gastroesophageal reflux presenting with stridor, feeding cyanosis, and failure to thrive

  • 양미애 (서울대학교 의과대학 소아과학교실) ;
  • 강민재 (서울대학교 의과대학 소아과학교실) ;
  • 홍지나 (서울대학교 의과대학 소아과학교실) ;
  • 신승한 (서울대학교 의과대학 소아과학교실) ;
  • 김상덕 (서울대학교 의과대학 소아과학교실) ;
  • 김이경 (서울대학교 의과대학 소아과학교실) ;
  • 김한석 (서울대학교 의과대학 소아과학교실) ;
  • 최중환 (서울대학교 의과대학 소아과학교실) ;
  • 권택균 (서울대학교 의과대학 이비인후과학교실) ;
  • 김인원 (서울대학교 의과대학 영상의학과학교실)
  • Yang, Mi Ae (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Kang, Min Jae (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Hong, Jeana (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Shin, Seung Han (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Kim, Sang Duk (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Kim, Ee-Kyung (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Kim, Han-Suk (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Choi, Jung-Hwan (Department of Pediatrics, Seoul National University, College of Medicine) ;
  • Kwon, Tack Kyun (Department of Otorhinolaryngology, Seoul National University, College of Medicine) ;
  • Kim, In-One (Department of Radiology, Seoul National University, College of Medicine)
  • 투고 : 2008.02.02
  • 심사 : 2008.03.07
  • 발행 : 2008.07.15
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초록

후두개 낭종은 신생아 및 영아에서 협착음을 일으킬 수 있는 드문 질환이지만, 이 질환에 이환된 환아는 갑작스런 기도 협착을 일으켜 사망할 수도 있다. 따라서, 협착음을 보이는 환아에서 후두개 낭종을 감별해 냄으로써 갑작스런 기도 협착으로 인한 사망을 방지할 수 있다. 후두개 낭종은 협착음, 쉰목소리, 흉골 함몰, 무호흡, 수유시 청색증 및 성장 장애를 일으킬 수 있는 질환으로 이 질환이 의심되면 굴곡성 후두경으로 진단해야 한다. 이 질환의 치료는 $CO_2$ 레이저를 이용한 후두미세수술이며, 적절한 치료를 통해 재발을 방지할 수 있다. 저자들은 협착음, 쉰목소리, 흉골 함몰, 수유시 청색증 및 성장 장애를 주소로 전원된 1개월 남아에서 굴곡성 후두경을 통해 후두개 낭종을 진단하였고, $CO_2$ 레이저를 통한 후두미세수술 후 증상이 호전된 증례 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with various degrees of feeding problems resulting in failure to thrive. When a vallecular cyst is suspected clinically, endoscopic laryngoscopy is necessary to visualize it. Other conditions leading to neonatal stridor such as laryngomalacia and other laryngotracheal abnormalities should be ruled out. Marsupialization with a $CO_2$ laser is the most effective and safest treatment to prevent recurrence. We report a case of a 1-month-old male infant with a vallecular cyst synchronous with gastroesophageal reflux, and failure to thrive. He was referred to our hospital because of hoarseness, inspiratory stridor, feeding-cyanosis, chest retraction and failure to thrive. Diagnostic workup revealed a cyst at the tongue base, suggesting a vallecular cyst. The cyst was removed by laryngomicrosurgery with $CO_2$ laser. After the surgery, the symptoms improved and the body weight increased steadily. We report a successfully treated case of neonatal vallecular cyst with symptoms of upper respiratory obstruction, gastroesophageal reflux, and failure to thrive.

키워드

참고문헌

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피인용 문헌

  1. Congenital vallecular cyst in an infant: case report and review of 52 recent cases vol.125, pp.11, 2008, https://doi.org/10.1017/s0022215111001368
  2. Vallecular Cyst in Neonates: Case Series—A Clinicosurgical Insight vol.2014, pp.None, 2008, https://doi.org/10.1155/2014/764860