Cantarella G, Neglia C B, Marzano A V, Ottaviani A
Department of Otolaryngology, University of Milan, Italy.
Ann Otol Rhinol Laryngol. 2001 Mar;110(3):263-7. doi: 10.1177/000348940111000311.
Xanthoma disseminatum is a rare non-Langerhans' cell histiocytosis, characterized by papular cutaneous eruption, possible mucosal involvement, and frequent association with vasopressin-sensitive diabetes insipidus. Herein we report a case of xanthoma disseminatum with pharyngolaryngeal involvement. In this patient, mucosal xanthomas involving the arytenoid cartilages and the interarytenoid area resulted in laryngeal stenosis and severe impairment of both cricoarytenoid joints' motility. Endoscopic CO2 laser medial arytenoidectomy, according to the technique described by Crumley (1993), and vaporization of interarytenoid xanthomas were successfully performed, thus reestablishing bilateral cordal motility and the laryngeal airway. Four years later, a CO2 laser revision was necessary because of recurrence of xanthomas in the posterior larynx. Two years after the latter operation, the patient has no signs of laryngeal obstruction and has a normal voice quality. This case report suggests that endoscopic medial arytenoidectomy may be successfully used in the treatment of bilateral laryngeal pseudoparalysis secondary to xanthoma disseminatum.
播散性黄瘤是一种罕见的非朗格汉斯细胞组织细胞增多症，其特征为丘疹性皮肤疹、可能累及黏膜，并常与血管加压素敏感性尿崩症相关。在此，我们报告一例累及咽喉的播散性黄瘤病例。在该患者中，累及杓状软骨和杓间区的黏膜黄瘤导致喉狭窄以及双侧环杓关节活动严重受损。根据Crumley（1993年）描述的技术，成功实施了内镜下二氧化碳激光杓状软骨内侧切除术以及杓间区黄瘤汽化术，从而恢复了双侧声带活动和喉气道。四年后，由于喉后部黄瘤复发，需要进行二氧化碳激光翻修手术。后一次手术后两年，患者无喉梗阻迹象，嗓音质量正常。本病例报告表明，内镜下杓状软骨内侧切除术可成功用于治疗播散性黄瘤继发的双侧喉假性麻痹。
