발관 2개월 후 갑자기 심해진 협착음과 호흡곤란으로 나타난 성문하 낭종
An infant with subglottic cysts presenting as abruptly-progressed stridor and respiratory distress 2 months after extubation
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Subglottic cysts are rare but can cause significant airway obstruction that potentially threatens infants’ lives. It is critically important to suspect subglottic cysts in infants with upper-airway obstructive symptoms because it can be treated effectively with only marsupialization without tracheostomy or complicated surgery. Here, we report an infant case of subglottic cyst, who showed prominent stridor and respiratory distress that abruptly progressed 2 months after extubation. The patient was born prematurely and had a history of endotracheal intubation in for a total of 16 days. He was stable with minimal stridor without respiratory distress until he was successfully discharged from the neonatal intensive care unit. However, he showed abrupt progress in stridor and respiratory difficulty about 2 weeks after discharge. Laryngoscopic exam revealed multiple subglottic cysts obstructing the trachea, and all of them were successfully removed by marsupialization. No recurrence of subglottic cysts was observed for 12 months thereafter. Subglottic cysts should be primarily suspected in infants with stridor, especially with a history of prematurity and intubation. Increased awareness of this fatal but curable condition is needed for timely and proper management.
Abstract
Subglottic cysts are rare but can cause significant airway obstruction that potentially threatens infants’ lives. It is critically important to suspect subglottic cysts in infants with upper-airway obstructive symptoms because it can be treated effectively with only marsupialization without tracheostomy or complicated surgery. Here, we report an infant case of subglottic cyst, who showed prominent stridor and respiratory distress that abruptly progressed 2 months after extubation. The patient was born prematurely and had a history of endotracheal intubation in for a total of 16 days. He was stable with minimal stridor without respiratory distress until he was successfully discharged from the neonatal intensive care unit. However, he showed abrupt progress in stridor and respiratory difficulty about 2 weeks after discharge. Laryngoscopic exam revealed multiple subglottic cysts obstructing the trachea, and all of them were successfully removed by marsupialization. No recurrence of subglottic cysts was observed for 12 months thereafter. Subglottic cysts should be primarily suspected in infants with stridor, especially with a history of prematurity and intubation. Increased awareness of this fatal but curable condition is needed for timely and proper management.
참고문헌 (15)
- Wani TM, "Age-based analysis of pediatric upper airway dimensions using computed tomography imaging", Pediatr Pulmonol, 51, pp.267~271 (2016)
- Wigger JH, "Fatal laryngeal obstruction by iatrogenic subglottic cysts", J Pediatr, 72, pp.815~820 (1968)
- Agada FO, "Subglottic cysts in children : a 10-year review", Int J Pediatr Otorhinolaryngol, 70, pp.1485~1488 (2006)
- See GB, "Stridor secondary to acquired subglottic cyst : rarity makes it missed", Indian J Otolaryngol Head Neck Surg, 71, pp.45~48 (2019)
- Bowles P, "Subglottic cysts : the Great Ormond Street experience in 105 patients", Eur Arch Otorhinolaryngol, 278, pp.2137~2141 (2021)
- Watson GJ, "Acquired paediatric subglottic cysts : a series from Manchester", Int J Pediatr Otorhinolaryngol, 71, pp.533~538 (2007)
- Zawadzka-Glos L, "Difficulties in diagnosis of laryngeal cysts in children", Int J Pediatr Otorhinolaryngol, 73, pp.1729~1731 (2009)
- Lim J, "Subglottic cysts : the Great Ormond street experience", Int J Pediatr Otorhinolaryngol, 67, pp.461~465 (2003)
- Johnson LB, "Acquired subglottic cysts in preterm infants", J Otolaryngol, 34, pp.75~78 (2005)
- Mandal A, "Upper airway obstruction in children", Indian J Pediatr, 82, pp.737~744 (2015)
- Richardson MA, "Management of pediatric subglottic cysts using the Bugbee fulgurating electrode", JAMA Otolaryngol Head Neck Surg, 140, pp.164~168 (2014)
- Halimi C, "Acquired subglottic cysts : management and long term outcome", Int J Pediatr Otorhinolaryngol, 76, pp.589~592 (2012)
- Steehler MK, "Management of subglottic cysts with Mitomycin-C—a case series and literature review", Int J Pediatr Otorhinolaryngol, 75, pp.360~363 (2011)
- Oh HS, "A case of pediatric subglottic stenosis caused by subglottic cyst", Korean J Head Neck Oncol, 34, pp.77~80 (2018)
- Ng C, "PO-0641 Paediatric subglottic cysts : risk factors and prevention – case control study", Arch Dis Child, 99, pp.A463~ (2014)