山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (6): 58-60.doi: 10.6040/j.issn.1673-3770.0.2016.220

• 论著 • 上一篇    下一篇

急性扁桃体炎致甲状腺脓肿、咽旁间隙脓肿一例并文献复习

孙臻峰,张佳,苏甜甜,董频   

  1. 上海市第一人民医院耳鼻咽喉头颈外科, 上海 200080
  • 收稿日期:2016-05-15 出版日期:2016-12-16 发布日期:2016-12-16
  • 作者简介:孙臻峰. E-mail:sun_zhenf@aliyun.com

Diagnosis and treatment of thyroid abscess and parapharyngeal space abscess caused by acute tonsillitis: a case report and literature review.

SUN Zhenfeng, ZHANG Jia, SU Tiantian, DONG Pin   

  1. Department of Otorhinolaryngology &Head and Neck Surgery, Shanghai General Hospital, Shanghai 200080, China
  • Received:2016-05-15 Online:2016-12-16 Published:2016-12-16

摘要: 目的 探讨急性扁桃体炎引起甲状腺脓肿继而导致颈部间隙脓肿的病因,研究其感染可能的发展途径及治疗手段的利弊。 方法 依照CT所示进行颈侧切开、开放所有颈部间隙,充分冲洗引流。 结果 经过颈侧切开,颈部间隙充分开放引流后,患者体温逐日下降,10 d恢复正常。 结论 B超、增强CT是鉴别颈部囊肿与脓肿有效手段,穿刺病理诊断是鉴别的金标准。口腔、颌面部感染同时出现甲状腺囊肿样结节要警惕脓肿形成。颈侧切开、充分冲洗引流是治疗咽旁间隙脓肿的有效手段。

关键词: 扁桃体炎, 甲状腺脓肿, 咽旁间隙感染

Abstract: Objective To analyze the etiology, route of infection, and treatment of a thyroid abscess caused by acute tonsillitis, which finally resulted in parapharyngeal space infection. Methods According to CT results, the site was incised laterally to reveal the neck space thoroughly. After that, the abscess was drained and rinsed carefully. Results The patients temperature lowered day by day, and the patient recovered after 10 days. Conclusion B ultrasound combined with enhanced CT is an effective means for the identification of neck cyst and abscess. Puncture pathological examination is the gold standard for diagnosis. If oral or maxillofacial infections are concurrent with thyroid cyst, special attention should be paid to abscess formation. Lateral neck incision, adequate irrigation and drainage are effective means to treat pharyngeal space abscess.

Key words: Thyroid abscess, Infection of parapharyngeal space, Tonsillitis

中图分类号: 

  • R653
[1] Wong D K, Brown C, Mills N, et al. To drain or not to drain-management of pediatric deep neck abscesses: a case-control study[J]. Int J Pediatr Otorhinolaryngol, 2012, 76(12):1810-1813.
[2] 王利军.甲状腺脓肿的CT诊断[J]. 包头医学,2008,32(1):12-13.
[3] Novis S J, Pritchett C V, Thorne M C, et al. Pediatric deep space neck infections in U.S. children, 2000-2009[J]. Int J Pediatr Otorhinolaryngol, 2014, 78(5):832-836.
[4] 张露,于鸿滨. 咽旁间隙脓肿16例临床诊疗体会[J]. 昆明医科大学学报,2014,35(5):147-148.
[5] 燕山,詹维伟,周建桥.甲状腺与甲状腺超声影像学[M].北京:科学技术文献出版社,2009:186.
[6] Álvarez Garcia N, Burgués Prades P, González Martínez-Pardo N, et al. The intra-thyroid thyroglossal cyst in the differential diagnosis of the solitary thyroid nodule: A presentation of 2 cases[J]. An Pediatr(Barc), 2015, 82(5):360-361.
[7] Yoon J H, Kim E K, Kwak J Y, et al. Effectiveness and limitations of core needle biopsy in the diagnosis of thyroid nodules: review of current literature[J]. J Pathol Transl Med, 2015, 49(3):230-235.
[8] Elsherif A M, Park A H, Alder S C, et al. Indicators of a more complicated clinical course for pediatric patients with retropharyngeal abscess[J]. Int J Pediatric Otorhinolaryngol, 2010, 74:198-201.
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