三例放射治疗后持续性喉水肿病例

Takaya Ito, Ryo Wakita, Yukiko Ichihashi, Chihiro Kutsumizu, Chihiro Suzuki, Naomi Shimada, Shigeru Maeda
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摘要

头颈部癌症的放射治疗(RT)近年来取得了显著进展,是主要的治疗方式之一,因为它可以在治疗后保留器官的功能和形态。然而,RT在广泛应用的同时,并发症也时有报道,尤其是喉头水肿,这可能会成为全身麻醉时的气道管理问题。本文介绍的 3 例 RT 引起的喉水肿病例中,第一例在 RT 术后 4 天发病,第二例在 RT 术后 4 年和 4 个月出现喉水肿相关体征和症状,第三例尽管没有临床体征和症状,但在 RT 术后十多年出现了严重的喉水肿。既往接受过头颈部RT的患者可能会因喉头水肿而在气道管理方面遇到困难。因此,术前对气道进行评估并制定包含各种设备和技术的综合气道管理计划至关重要。
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Three Cases of Persistent Laryngeal Edema Postradiation Therapy.

Radiation therapy (RT) for head and neck cancer, which has made remarkable progress in recent years, is one of the main treatment modalities because it can preserve organ function and morphology after treatment. However, while RT is widely used, complications have been reported, especially laryngeal edema, which can be an airway management problem during general anesthesia. Of the 3 cases of RT-induced laryngeal edema presented here, the first developed 4 days post-RT, the second manifested signs and symptoms associated with laryngeal edema after RT performed 4 years and 4 months previously, and the third exhibited severe laryngeal edema over a decade post-RT despite the absence of clinical signs and symptoms. Patients with a previous history of RT involving the head and neck region may encounter challenges in airway management due to laryngeal edema. Therefore, it is crucial to assess the airway preoperatively and devise a comprehensive airway management plan that encompasses various devices and techniques.

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