생후 35일부터 호흡곤란을 보였던 선천성 성대하 혈관종 1례 (A Case of Congenital Subglottic Hemangioma In An Infant)

서지정보

· 발행기관 : 고신대학교(의대) 고신대학교 의과대학 학술지
· 수록지 정보 : 고신대학교 의과대학 학술지 / 20권 / 1호 / 1 ~ 5페이지
· 저자명 : 오지은, 노은석, 박재선, 이강대, 김영옥, 정미희

초록

We report a case of subglottic hemangioma in an 40 days old male infant. Since 35th days of birth, he developed sudden onset of dyspnea, hoarseness, and biphasic stridors. Stridors were more prominent in inspiratory phase than expiratory phase, and were not relieved by prone positioning. Fiberscope of vocal cord was tried, but unsuccessful to make any diagnosis because of the extreme severity of the respiratory distress during the examination. Steroids were maintained for 7 days, but there was no symptomatic improvement. Emergent tracheotomy was done as signs of air hunger were aggravated in spite of oxygen supply. Neck axial CT study was possible only after tracheostomy, and it showed a small caliber trachea which was displaced to the left side. Sagittal reconstruction neck CT scan showed no connection in the upper airway. Diagnostic approach with direct laryngoscope was made in the operating room which revealed round mass located posteroinferiorly of left vocal cord. The mass, covered by normal mucosa and 1x1x1 cm in size, was ablated with CO2 laser. Sections of resected subglottic mass showed lobular proliferation of small vessels which is compatible with hemangioma. After 3 weeks of tracheostomy, decannulation was done successfully without any complication. Follow-up examination of the baby at one year of age showed excellent condition except small hemangioma of 1x1.5cm size on the skin of posterior chest wall, which was newly developed at age of 3 months.

영어초록

We report a case of subglottic hemangioma in an 40 days old male infant. Since 35th days of birth, he developed sudden onset of dyspnea, hoarseness, and biphasic stridors. Stridors were more prominent in inspiratory phase than expiratory phase, and were not relieved by prone positioning. Fiberscope of vocal cord was tried, but unsuccessful to make any diagnosis because of the extreme severity of the respiratory distress during the examination. Steroids were maintained for 7 days, but there was no symptomatic improvement. Emergent tracheotomy was done as signs of air hunger were aggravated in spite of oxygen supply. Neck axial CT study was possible only after tracheostomy, and it showed a small caliber trachea which was displaced to the left side. Sagittal reconstruction neck CT scan showed no connection in the upper airway. Diagnostic approach with direct laryngoscope was made in the operating room which revealed round mass located posteroinferiorly of left vocal cord. The mass, covered by normal mucosa and 1x1x1 cm in size, was ablated with CO2 laser. Sections of resected subglottic mass showed lobular proliferation of small vessels which is compatible with hemangioma. After 3 weeks of tracheostomy, decannulation was done successfully without any complication. Follow-up examination of the baby at one year of age showed excellent condition except small hemangioma of 1x1.5cm size on the skin of posterior chest wall, which was newly developed at age of 3 months.

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