楕円形輪状軟骨による声門下狭窄1剖検例を通しての検討

Congenital Subglottic Stenosis due to Elliptical Cricoid Cartilage

I．緒言

　先天性声門下狭窄（以下，声門下狭窄と略）は先天性喘鳴の原因として数多く報告されている。しかしその多くは内視鏡，あるいは手術時の所見に基づいており，剖検により狭窄部位の形態学的特徴について考察した報告は少ない。今回私どもは声門下狭窄で死亡した生後1か月の乳児の剖検例を経験した。病歴の詳細はすでに報告^1）済であるが，今回はとくに狭窄部位の形態学的特徴について考察を加えたい。

A 40-day-old boy who presented stridor since his birth suddenly died of upper respiratory ob-struction without a sign of infection. Autopsy findings showed an elliptical shaped cricoid car-tilage, outer diameter of which was 8.5mm anteroposteriorly and 6mm transversely. The inner diameter of a slit-like lumen was 5mm anteroposteriorly and 1.5mm transversely. The width of the lumen was extremely narrow com-paring with that of normal cricoids obtained from four infant cadavers of the same age (4.5±0.61 mm).

We classify the shape of the cricoid cartilage in congenital subglottic stenosis into 3 types according to the embryological hypothesis after Walander.