Wang Hui-ge, Lin Xin-qiang
Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China.
Zhonghua Er Bi Yan Hou Ke Za Zhi. 2003 Dec;38(6):421-5.
To evaluate some perplexing problems in the diagnosis and treatment of juvenil recurrent laryngeal papillomatosis (JRLP) and the relationship between juvenile onset recurrent respiratory papillomatosis(JORRP) and infantile laryngeal condyloma accuminatum (ILCA).
A group of 44 cases with JRLP were analyzed retrospectively from March, 1994 to March, 2002 in the light of literature review.
The average age of first visit was 1.6 years. Average 5.3 operations had been performed per patient. There was an interval of average 2.4 months between two surgical excisions. Of 233 operations, the total incidence rate of all the complications was 3.9%. At present, the laryngeal lesion of 18 cases have withered away for over 1 year. 11 cases have being followed up. 10 cases have lost follow-up and 5 cases have died (11.4%). Combined laryngeal lesion excision with tracheotomy aiming at prolonging operative interval or Chinese traditional medicine has received more satisfactory effect than other therapies. There is an extensive similarity between JORRP and ILCA.
To demondrate further whether JORRP and ILCA are the same identical disease has important significance in both theoretical study and clinic practice. The treatment for JRLP is still difficult. The tracheotomy for laryngeal obstruction resulted from the laryngeal lesion of JRLP should be avoided as far as possible. Combined laryngeal lesion excision with tracheotomy aiming at prolonging opertive interval or Chinese traditional medicine shows optimistic prospect.
评估青少年复发性喉乳头状瘤病(JRLP)诊断与治疗中一些令人困惑的问题,以及青少年起病的复发性呼吸道乳头状瘤病(JORRP)与婴儿喉尖锐湿疣(ILCA)之间的关系。
回顾性分析1994年3月至2002年3月间一组44例JRLP患者,并结合文献复习。
首次就诊的平均年龄为1.6岁。每位患者平均接受5.3次手术。两次手术切除之间的平均间隔为2.4个月。在233次手术中,所有并发症的总发生率为3.9%。目前,18例患者的喉部病变已消退超过1年。11例患者正在接受随访。10例患者失访,5例患者死亡(11.4%)。联合喉部病变切除并气管切开以延长手术间隔或采用中药治疗比其他治疗方法效果更佳。JORRP和ILCA之间存在广泛的相似性。
进一步明确JORRP和ILCA是否为同一种疾病在理论研究和临床实践中均具有重要意义。JRLP的治疗仍然困难。应尽可能避免因JRLP喉部病变导致的喉梗阻而进行气管切开。联合喉部病变切除并气管切开以延长手术间隔或采用中药治疗显示出乐观的前景。