Faculdade de Medicina de Botucatu, Unesp.
Braz J Otorhinolaryngol. 2009 Jan-Feb;75(1):116-22. doi: 10.1016/s1808-8694(15)30842-9.
Granulomas are bilateral and pediculated lesions of the vocal apophysis. Etiologies: intubation, reflux, trauma, vocal abuse, idiopathic origin.
To analyze the clinical and morphological aspects of post intubation granulomas.
retrospective study of patients submitted to microsurgery for post intubation laryngeal granulomas seen at our Medical School starting in 2002. We analyzed: age, gender, indication and time of intubation, symptoms, videolaryngoscopic diagnosis and biopsy findings. Light microscopy was performed on all specimens, and electron microscopy on three of them.
ten patients (7 females and 3 males), between the ages of 2 and 72 years, intubation time between 4h and 21 days. Hoarseness was a frequent symptom, starting in the first week following extubation. Histology shows mild epithelial hyperplasia, severe inflammation and vessel proliferation in the corion. Under SEM, the epithelium presented mild superficial desquamation. Under TEM, intracellular junctions showed widening with structural changes in the desmosomes. In the corion there were vessel proliferations, inflammation and fibroblasts with structural alterations.
post intubation granulomas appear in any age and hoarseness is a frequent symptom. Morphological alterations occur in the corion as vessel proliferations, inflammation, and intracytoplasmatic alterations in fibroblasts suggesting cellular dysfunction and damage.
声带突的双侧带蒂性肉芽肿。病因：插管、反流、创伤、滥用嗓音、特发性。
分析插管后肉芽肿的临床和形态学特征。
对 2002 年以来我院医学院接受显微手术治疗的插管后喉肉芽肿患者进行回顾性研究。我们分析了：年龄、性别、插管指征和时间、症状、喉镜诊断和活检结果。所有标本均行光镜检查，其中 3 例行电镜检查。
10 例患者（7 名女性和 3 名男性），年龄 2-72 岁，插管时间 4 小时至 21 天。声嘶是常见症状，在拔管后第一周开始出现。组织学显示轻度上皮增生，外膜严重炎症和血管增生。在 SEM 下，上皮表现为轻度浅表性脱屑。在 TEM 下，细胞间连接变宽，桥粒结构发生变化。外膜有血管增生、炎症和结构改变的成纤维细胞。
插管后肉芽肿可发生于任何年龄，声嘶是常见症状。外膜出现血管增生、炎症和细胞内成纤维细胞结构改变，提示细胞功能障碍和损伤。
