喉頭神経鞘腫の1例

概要

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A 73-year-old man with a supraglottic tumor was referred to our clinic by a gastroenterologist. A mass was found during a thorough medical checkup, and the gastroenterologist assumed that it would soon block the patient’s airway. The referring gastroenterologist therefore suggested performing emergency surgery. A laryngeal fiberscope inserted via the nasal cavity revealed a large mass within the left false vocal cord which almost completely blocked the glottis. We originally thought that the mass was adhering to the glottis. Although we asked the patient to assume numerous positions, the mass did not appear to be adhering to the glottis and stridor or dyspnea did not occur. After showing the video of his larynx to the patient, we removed the mass safely in phonomicrosurgery 5 days after his first visit. The mass was a 13×17-mm laryngeal neurinoma. This case illustrates that careful fiberscopic examination and consideration of the individual patient’s condition can avoid the need for emergency surgery, and that an airwayscope is a useful tool for inserting a tracheal tube in patients with large laryngeal masses to prevent airway obstruction.