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Abstract：
OBJECTIVE: To review the literature of congenital hairy polyps and describe the clinical presentation, operative management, and histologic findings of a congenital hairy polyp arising from the palatopharyngeus muscle in a neonate with recurrent choking episodes.
METHODS: Chart review of a 2-month-old male referred to a tertiary care pediatric hospital.
RESULTS: We present a case of a 2-month-old male who presented to the emergency room with recurrent episodes of choking and vomiting. The patient was previously healthy with no prior medical or neonatal history. The parents noted a small fleshy mass in the patient\'s oropharynx that he would chew on and swallow after several minutes. However, on physical exam, there was no evidence of oropharyngeal mass. The patient did not have respiratory distress. Imaging revealed a 22×7×11mm oblong, fatty mass in the lower cervical and upper thoracic esophagus with a thin stalk extending proximally to the upper collapsed esophagus. Intraoperative recorded laryngoscopy revealed a pedunculated soft palate mass attached to the right superior palatopharyngeus muscle. Histopathology revealed ectodermal and mesodermal elements in a polypoid structure lined by keratinizing squamous epithelium with adnexal structures and central mature adipose tissue, consistent with congenital hairy polyp resembling an accessory tragus of the ear and branchial anomaly. At 6-week follow up, the patient was doing well and gaining weight appropriately with no further choking episodes. There was no evidence of velopharyngeal dysfunction on follow up exam. The surgical site was completely healed and there was no evidence of recurrence.
CONCLUSIONS: Congenital hairy polyps of the naso- and oropharynx are rare but may present as airway or esophageal masses, causing respiratory distress or choking episodes in a pediatric patient. The pathologic findings of keratinizing squamous epithelium, adnexal structures, adipose and cartilage tissues resemble congenital accessory tragus and may be considered a branchial arch anomaly.
METHODS: Chart review of a 2-month-old male referred to a tertiary care pediatric hospital.
RESULTS: We present a case of a 2-month-old male who presented to the emergency room with recurrent episodes of choking and vomiting. The patient was previously healthy with no prior medical or neonatal history. The parents noted a small fleshy mass in the patient\'s oropharynx that he would chew on and swallow after several minutes. However, on physical exam, there was no evidence of oropharyngeal mass. The patient did not have respiratory distress. Imaging revealed a 22×7×11mm oblong, fatty mass in the lower cervical and upper thoracic esophagus with a thin stalk extending proximally to the upper collapsed esophagus. Intraoperative recorded laryngoscopy revealed a pedunculated soft palate mass attached to the right superior palatopharyngeus muscle. Histopathology revealed ectodermal and mesodermal elements in a polypoid structure lined by keratinizing squamous epithelium with adnexal structures and central mature adipose tissue, consistent with congenital hairy polyp resembling an accessory tragus of the ear and branchial anomaly. At 6-week follow up, the patient was doing well and gaining weight appropriately with no further choking episodes. There was no evidence of velopharyngeal dysfunction on follow up exam. The surgical site was completely healed and there was no evidence of recurrence.
CONCLUSIONS: Congenital hairy polyps of the naso- and oropharynx are rare but may present as airway or esophageal masses, causing respiratory distress or choking episodes in a pediatric patient. The pathologic findings of keratinizing squamous epithelium, adnexal structures, adipose and cartilage tissues resemble congenital accessory tragus and may be considered a branchial arch anomaly.
摘要：
目的：回顾先天性毛状息肉的文献并描述其临床表现，操作管理，以及在反复窒息发作的新生儿中，由腭咽肌引起的先天性毛状息肉的组织学发现。
方法：对一名2个月大的男性转诊到三级儿科医院进行图表回顾。
结果：我们介绍了一例2个月大的男性，因反复出现窒息和呕吐而出现在急诊室。患者以前是健康的，没有既往病史或新生儿史。父母注意到患者的口咽部有一个小的肉质肿块，几分钟后他会咀嚼和吞咽。然而,体检时,没有口咽肿块的证据.患者没有呼吸窘迫。成像显示一个22×7×11mm的长方形，下颈和上胸段食管中的脂肪块，细茎向近端延伸至上塌陷的食管。术中记录的喉镜检查显示，有一个带蒂的软腭肿块附着在右上腭咽肌上。组织病理学显示，外胚层和中胚层成分呈息肉状结构，由角化鳞状上皮与附件结构和中央成熟脂肪组织衬砌，与先天性毛状息肉一致，类似于耳朵的副耳屏和分支异常。在6周的随访中，患者情况良好,体重适当增加,没有进一步窒息发作.在随访检查中没有证据表明咽喉功能障碍。手术部位完全愈合，无复发迹象。
结论：先天性鼻和口咽毛状息肉少见，但可表现为气道或食管肿块，导致儿科患者呼吸窘迫或窒息发作。角化鳞状上皮的病理发现，附件结构，脂肪和软骨组织类似于先天性副耳屏，可能被认为是支气管弓异常。
方法：对一名2个月大的男性转诊到三级儿科医院进行图表回顾。
结果：我们介绍了一例2个月大的男性，因反复出现窒息和呕吐而出现在急诊室。患者以前是健康的，没有既往病史或新生儿史。父母注意到患者的口咽部有一个小的肉质肿块，几分钟后他会咀嚼和吞咽。然而,体检时,没有口咽肿块的证据.患者没有呼吸窘迫。成像显示一个22×7×11mm的长方形，下颈和上胸段食管中的脂肪块，细茎向近端延伸至上塌陷的食管。术中记录的喉镜检查显示，有一个带蒂的软腭肿块附着在右上腭咽肌上。组织病理学显示，外胚层和中胚层成分呈息肉状结构，由角化鳞状上皮与附件结构和中央成熟脂肪组织衬砌，与先天性毛状息肉一致，类似于耳朵的副耳屏和分支异常。在6周的随访中，患者情况良好,体重适当增加,没有进一步窒息发作.在随访检查中没有证据表明咽喉功能障碍。手术部位完全愈合，无复发迹象。
结论：先天性鼻和口咽毛状息肉少见，但可表现为气道或食管肿块，导致儿科患者呼吸窘迫或窒息发作。角化鳞状上皮的病理发现，附件结构，脂肪和软骨组织类似于先天性副耳屏，可能被认为是支气管弓异常。
