輪状軟骨骨折と声門下異物との鑑別に苦慮した小児声門下狭窄の1例

Abstract

Various factors, including tracheal intubation, trauma, burns, foreign bodies, infections, and tumors, can cause subglottic stenosis. Diagnosing the cause of stenosis is often difficult, and interviewing the patient is useful for achieving an accurate diagnosis; however, dyspnea due to subglottic stenosis can make it difficult for the patient to speak, or the patient may not be aware of the reason for their stenosis. We herein report a nine-year-old girl with subglottic stenosis. She suffered from wheezing, and had been treated for upper respiratory inflammation at a local clinic. As the wheezing was worsening, she was sent to our hospital. Computed tomography showed subglottic stenosis, and emergency tracheostomy was performed. Fiberscope showed swollen subglottic mucosa, but the reason for the stenosis was unclear. Four months later, while the swollen mucosa had improved, she still suffered from sputum and cough. A deep investigation with laryngoscopy was planned under general anesthesia. A foreign body was found under the vocal cords, and removed. After the surgery, the patient’s entire condition improved. As ingestion of foreign bodies does not show specific symptoms, patients might be treated as having respiratory inflammation. We should never forget the possibility of foreign body ingestion in such cases.