小児内頸静脈拡張症 : 5症例手術治験のまとめ

概要

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Five cases of internal jugular phlebectasia were reported. All patients were infants aged 3 to 6. They were well developed and apparently healthy, and there had been no operation nor any trauma. A soft enormous swelling appeared low in the right side of the neck only during forcible phonation, breath holding after deep inspiration or straining, which increase intrathoracic pressure. Whenever they relaxed, however, no swelling could be seen or felt at all. They were diagnosed as internal jugular phlebectasia by this characteristic swelling in the neck. Operative treatment was performed by ligation of the internal jugular vein at three points, high at the level of the thyroid cartilage, low at just superior to the clavicle and at the level of communication to the middle thyroid vein. Thinning of the carotid sheath was definitly seen in all cases. Pathohistological examination of the excised jugular vein, on the contrary, reuealed no deterioration of its components except slight thinning of the wall, which was considered to be a secondary change due to repeated expansion. Bibliographical studies were done and the possible causes of this internal jugular phlebectasia were discussed. We consider that thinning and change in quality of the carotid sheath may be one of genetically important factors of this desease.
社団法人日本耳鼻咽喉科学会の論文