Wani M K, Woodson G E
Department of Otolaryngology, University of Tennessee, Memphis, School of Medicine, 38163, USA.
Laryngoscope. 1999 Oct;109(10):1589-93. doi: 10.1097/00005537-199910000-00008.
To report outcomes of treatment for laryngeal contact granuloma.
Prospective treatment of 21 patients with laryngeal contact granulomas using proton-pump inhibitor (PPI) medication.
Patients were diagnosed and followed by office endoscopy and patient interview.
Three patients did not tolerate PPI medication and were managed by treatment with type 2 histamine (H2) blockers. The lesion completely resolved in 14 of the 18 patients maintained on PPI medication, and significantly regressed in the other 4. Residual granulomas were surgically excised in one patient. Lesions resolved in two patients following injection of botulinum toxin into one thyroarytenoid muscle. One patient had a residual lesion, but symptoms were controlled by medication, and he declined treatment with botulinum toxin. Of the three patients treated with H2-blocker medication, the lesion resolved in only one.
PPI medication is effective in the treatment of laryngeal contact granuloma, even in the absence of identifiable symptoms of gastroesophageal reflux.
报告喉接触性肉芽肿的治疗结果。
对21例喉接触性肉芽肿患者采用质子泵抑制剂(PPI)药物进行前瞻性治疗。
通过门诊内镜检查和患者访谈对患者进行诊断和随访。
3例患者不耐受PPI药物,改用2型组胺(H2)受体阻滞剂治疗。在持续使用PPI药物治疗的18例患者中,14例病变完全消退,另外4例明显缩小。1例患者残留的肉芽肿通过手术切除。2例患者在向一侧甲杓肌注射肉毒杆菌毒素后病变消退。1例患者有残留病变,但症状通过药物得到控制,他拒绝肉毒杆菌毒素治疗。在接受H2受体阻滞剂治疗的3例患者中,仅1例病变消退。
即使没有可识别的胃食管反流症状,PPI药物治疗喉接触性肉芽肿也有效。