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[喉部类脂蛋白沉积症的表现与治疗]

[Manifestation and treatment of lipoid proteinosis in larynx].

作者信息

Xu Wen, Wang Lei, Zhang Li, Liu Hong-gang, Zan Fang, Hu Rong, Liu Wen-bin, Han De-min

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing 100730, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Apr;45(4):301-4.

Abstract

OBJECTIVE

To investigate the manifestation, characteristics and treatment of lipoid proteinosis (LP) in larynx.

METHODS

Sixteen cases of LP with hoarseness as the first sign were reported. The onset was in the newborn period in 10 cases. The upper eyelids were infiltrated in all cases, 13 of them reported an age of onset older than 6 - 8 years. The laryngeal behaviors and its treatment, multisystem manifestations, and characteristics of histopathology were evaluated.

RESULTS

One patient had moderate hoarseness, and the others had severe hoarseness. Videolaryngoscopy revealed thickening of the interarytenoid region and irregularities along the rims and the surface of the vocal folds due to yellowish papules. Oral tissues showed yellow-white infiltrates in 13 cases (81.3%). Whitish moniliform papules on the upper eyelids were found in all cases. Pock-like or acneiform scars were particularly evident on the face and the limbs in 14 cases (87.5%). Histologically, it was characterized by deposition of hyaline material in the submucosa and dermis of the eyelid or larynx with periodic acid-Schiff-positive and Congo red stain-negative. Eight patients underwent microlaryngosurgery for the excision of deposits in the vocal folds. The vocal function was significantly improved after surgery.

CONCLUSIONS

One of the most common features of lipoid proteinosis is hoarseness since infancy with laryngeal involvement. LP patients also display skin or mucosa infiltration of multiple systems. Microlaryngosurgical excision of the deposits in the vocal fold could improve the voice.

摘要

目的

探讨喉部类脂蛋白沉积症(LP)的表现、特征及治疗方法。

方法

报告16例以声音嘶哑为首发症状的LP患者。10例发病于新生儿期。所有病例均有上睑浸润,其中13例报告发病年龄大于6 - 8岁。评估喉部表现及其治疗、多系统表现以及组织病理学特征。

结果

1例患者声音中度嘶哑,其余患者声音重度嘶哑。电子喉镜检查显示,由于淡黄色丘疹,杓间区增厚,声带边缘及表面不规则。13例(81.3%)口腔组织出现黄白色浸润。所有病例上睑均可见白色串珠状丘疹。14例(87.5%)患者面部和四肢出现痘状或痤疮样瘢痕尤为明显。组织学上,其特征为眼睑或喉部黏膜下层和真皮层有透明物质沉积,高碘酸-希夫染色阳性,刚果红染色阴性。8例患者接受了显微喉镜手术切除声带沉积物。术后发声功能明显改善。

结论

类脂蛋白沉积症最常见的特征之一是自婴儿期起即出现声音嘶哑并累及喉部。LP患者还表现出多系统的皮肤或黏膜浸润。显微喉镜手术切除声带沉积物可改善嗓音。

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