ラドンシード刺入照射後, 長期間経過し食道狭窄, 両側声帯固定を来たした1症例

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  • A Case of Adhesion of Both Vocal Cords and Esophageal Stenosis Caused by Radon Seed Implantation for a Long Term

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A case of a 57-year-old female suffering from adhesion of the vocal cords and esophageal stenosis was reported. In the course of treatment 40 years earlier for a papilloma in the larynx, she had received implantation of radon seeds. She had complained of aspiration difficulties and pneumonia several times. According to observations using a flexible fiberscope, both vocal cords were located in the lateral position, and the arytenoids were adhered to the posterior wall of the pharynx. Furthermore, both pyriform sinuses were completely closed. A small opening, less than 3mm, was detected between the postcricoid and pharynx, through which she could hardly ingest. An x-ray of the neck indicated that there were some radon seeds, each 3mm in length, located around the arytenoids. It was thought that the findings in the larynx and pharynx had been caused imperceptibly by inflammation and fibrosis following the implantation of the radon seeds. Surgery was performed to improve her dysphagia. First, incisions were made toward left pyriform sinus from a small opened-space located in the postcricoid via microsurgery. The hypopharynx was entered through the left pyriform sinus after the skin on the left side of the neck was incised vertically along the sternocleidmastoideus muscle. The adhesion at the level of the pyriform sinuses was cut sharply, and the left pyriform sinus was made by resuturing the mucous membrane of the hypopharynx so as to conceal the raw surface. Two years have passed since the surgery. The vocal cords have not moved and although she has suffered from hoarseness, she can now eat whatever she likes.

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