하인두 양성 질환의 내시경 치료
Endoscopic Treatment of Benign Hypopharyngeal Tumors
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초록
진단용 상부소화관 내시경 검사시 내시경 관찰은 구강, 하인두, 후두에서부터 시작되지만 흔히 내시경이 지나가는 통로로 인식하는 경우가 많으며 또한 삽입 당시 구역, 구토 등 환자의 고통을 최소화하기 위해서 내시경을 맹목적으로 삽입을 함으로써 인후두부를 관찰하지 않고 지나치는 경우가 많다. 그러나 내시경 검사는 먼저 구강과 인두를 통과하여 이루어지므로 주의를 기울여 이 부위의 이상 유무를 확인한다면 무증상 혹은 경미한 증상의 인후두 병변을 진단할 수 있다. 저자들은 최근 무증상, 상복부 통증 또는 이물감을 주소로 내원하여 시행한 상부소화관 내시경 검사에서 하인두 부위 이상을 발견하고 최종 진단 및 증상 소실 목적으로 내시경 시술로 특별한 합병증 없이 성공적으로 절제한 7명의 환자를 경험하였기에 문헌 고찰과 함께 이를 보고한다.
Abstract
During endoscopy, most endoscopists insert endoscopes into the esophagus without visual aid in order to minimize the discomfort to patients. However, studies have shown that visual guided insertion imposes little discomfort, is safe and can increase the diagnostic rate of abnormal pathology of the throat. As for the treatment of hypopharyngeal lesions, cases of endoscopic treatment are rare and any guidelines have not been clearly defined yet. However, endoscopic treatment may be feasible in selected cases. Several procedures, such as endoscopic mucosal resection with cap (EMR-C) and saline injection polypectomy can be applied. We experienced seven patients who had benign hypopharyngeal masses that were removed endoscopically without serious complications. Compared to surgical treatment, endoscopic removal of the benign hypopharyngeal tumors does not require general anesthesia; it is simple, less invasive and less costly. Therefore, endoscopy should be regarded as a treatment option. However, further studies are required before widespread application of endoscopic removal for the definitive treatment of hypopharyngeal masses, including malignancies.
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