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A case of postoperative nasopharyngeal reflux associated with retropharyngeal lymphangioma in newborn infant

수술 후 비인두 역류가 동반된 신생아의 후인두림프관종 1례

  • Koo, Kyo Yeon (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Lee, Jun Seok (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Lee, Soon Min (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Park, Min Soo (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Namgung, Ran (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Park, Kook In (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Lee, Chul (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Yoon, Choon Sik (Department of Radiology, Yonsei University College of Medicine) ;
  • Jung, Woo Hee (Department of Clinical Pathology, Yonsei University College of Medicine) ;
  • Choi,, Hong Shik (Department of Otorhinolaryngology, Yonsei University College of Medicine)
  • 구교연 (연세대학교 의과대학 소아과학교실) ;
  • 이준석 (연세대학교 의과대학 소아과학교실) ;
  • 이순민 (연세대학교 의과대학 소아과학교실) ;
  • 박민수 (연세대학교 의과대학 소아과학교실) ;
  • 남궁란 (연세대학교 의과대학 소아과학교실) ;
  • 박국인 (연세대학교 의과대학 소아과학교실) ;
  • 이철 (연세대학교 의과대학 소아과학교실) ;
  • 윤춘식 (연세대학교 의과대학 방사선과학교실) ;
  • 정우희 (연세대학교 의과대학 병리학교실) ;
  • 최홍식 (연세대학교 의과대학 이비인후과학교실)
  • Received : 2009.07.25
  • Accepted : 2009.11.02
  • Published : 2010.02.15

Abstract

Lymphangioma is a rare benign congenital tumor of the lymphatic system, which is commonly diagnosed before 2 years of age. In the natronal report, cystic lymphangioma was usually reported as a huge translucent mass located in the head and neck area. It's occurrence in retropharyngeal space with respiratory obstruction and swallowing difficulty in neonate is extremely rare and postoperative nasopharyngeal reflux has rarely been reported. Complete resection is the standard therapy. However, involvement of the upper airway may be determining prognosis in the extensive lymphangiomas because of the difficulty of complete excision. We present a case of cystic lymphangioma in neonate which was initially asymptomatic but gradually progressed to cause respiratory obstruction due to enlargement. After resection, nasopharyngeal reflux developed with dysfunction of the soft palate and gradually improved with conservative care over 5 months.

후인두림프관종은 무증상으로 시작되어 크기의 증가에 따라 주위 구조물들을 압박하여 호흡곤란이나 연하곤란 등의 2차적 증상들을 유발할 수도 있는 드문 양성 종양이다. 현재까지 치료는 수술에 의한 완전 적출이 원칙이나 기도 주변에 인접한 림프종의 경우에는 완전 적출이 어려워 예후가 나쁘다. 신생아에서 후인두림프관종이 보고 된 경우는 드물며, 수술 후에 비인두역류증이 발생된 경우는 극히 드물다. 이에 저자들은 생후 14일에 호흡곤란 및 연하곤란 증상을 보인 신생아에서 후인두림프관종을 진단하여 완전 적출술로 치료하였으며 수술 후에 비인두역류증이 일정 기간 지속되어 보존적 치료를 시행한 후 회복된 1례를 경험하였기에 이를 보고하고자 한다.

Keywords

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