Pharyngeal strictures and atresia
Introduction
Introduction to pharyngeal stenosis and atresia It is generally believed that the incomplete rupture of the buccal pharyngeal membrane causes congenital stenosis of the nasopharynx, and congenital nasopharyngeal atresia if the buccal pharyngeal membrane is not ruptured. Diagnosis: There is no airflow before the nostrils of cotton hair. After converging the nasal mucosa with a vasoconstrictor, the pharyngeal portion cannot be passed through the nasal cavity with a thin catheter or a fine probe. Dropping into the nasal cavity with methylene blue does not allow you to enter the pharynx. Nasal lipiodol angiography can determine the location of stenosis and atresia. Treatment: surgical treatment. For the membrane occlusion, a metal dilator can be inserted into the nasal cavity, the locking membrane can be inserted through the membrane, the perforation can be enlarged, and the locking membrane can be cut by a laser surgery machine. Clinical manifestations: manifested as symptoms of complete nasal congestion such as neonatal nasal congestion, difficulty breathing, cyanosis, and aggravation during breastfeeding. Check that there is a thin film between the trailing edge of the soft palate and the posterior pharyngeal wall. The surface is smooth and soft. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious complication:
Cause
Pharyngeal stenosis and the cause of atresia
1, trauma
(1) After the pharyngeal part is burned by the corrosive agent, the mucosa is extensively necrotic and ulcerated. At present, when the wound is in contact with the wound, it becomes scarred and even blocked.
(2) In the case of laryngeal trauma, the laryngeal body moves together with the posterior pharyngeal wall to form a laryngeal stenosis.
(3) Improper operation, when performing adenoidectomy, excessive mucosal damage may occur, and scarring may also occur.
2, special infections
Often caused by syphilis, leprosy, induration and other diseases, especially the formation of syphilis, often complicated by this disease.
3, congenital nasopharyngeal atresia
Both the normal and the posterior nostril at the same time exist.
Prevention
Pharyngeal stenosis and atresia prevention
In normal life, it is necessary to protect the pharynx and prevent damage to the pharynx. For newborns, there is no effective preventive measure, and attention should be paid to prenatal care.
Complication
Pharyngeal stenosis and atresia complications Complication
Symptoms such as difficulty breathing, cyanosis, etc. may occur. In severe cases, there may be nasal congestion, loss of olfactory or disappearance, snoring, mouth breathing, occlusive nasal sounds or ambiguous pronunciation.
Symptom
Symptoms of pharyngeal stenosis and atresia Common symptoms Nasal snoring Breathing difficulty Eustachian tube obstruction of olfactory dysfunction Cough and sputum Hearing loss
Nasopharyngeal stenosis or atresia: Nasal breathing is not smooth or completely blocked, there is an occlusive nasal sound when talking, can not blow nose, smell is dysfunctional, snoring while sleeping, if the eustachian tube is blocked, there is hearing impairment or otitis media. Patients with laryngeal lesions: According to the location and extent of the stenosis, it may be difficult to swallow, poor breathing and eating cough. Patients tend to be thin and weak due to chronic malnutrition.
Examine
Examination of pharyngeal stenosis and atresia
1. There is no airflow before the cotton wool is placed in the nostrils.
2. After converging the nasal mucosa with a vasoconstrictor, the pharyngeal portion cannot be passed through the nasal cavity with a thin catheter or a fine probe.
3. Do not enter the pharynx by dropping it into the nasal cavity. Nasal lipiodol angiography can determine the location of stenosis and atresia.
4. Imaging examination: CT, nasal and nasopharynx X-ray film
Diagnosis
Diagnosis of pharyngeal stenosis and atresia
diagnosis
Stenosis or atresia can be seen by oropharyngeal or indirect laryngoscopy. X-ray film and lipiodol imaging can further clarify the extent and thickness of the latching part.
Differential diagnosis
Identification with laryngeal lock:
The child has no breathing or crying after birth. Visible "four concave signs", but no air inhalation. At the time of birth, the color of the child was normal, but after the umbilical cord was ligated, it soon became convulsed. It is characterized by nasal congestion, difficulty in breathing, cyanosis, and aggravation of nasal congestion. Check that there is a thin film between the trailing edge of the soft palate and the posterior pharyngeal wall. The surface is smooth and soft.
