Department of Otolaryngology, Hilleroed Hospital, Dyrehavevej 29, 3400, Hilleroed, Denmark.
Eur Arch Otorhinolaryngol. 2011 Apr;268(4):575-80. doi: 10.1007/s00405-010-1449-y. Epub 2010 Dec 4.
Laryngeal sarcoidosis is rare (0.5% of patients with sarcoidosis), the pathogenesis is unknown and the optimal treatment remains a matter of debate. We undertook this study to elucidate possible pathogenic factors in clinically isolated laryngeal sarcoidosis and to describe results of supraglottoplastic surgery. From 1995 to 2009, we identified six patients with histologically proven sarcoidosis of the larynx treated at Rigshospitalet. All patients were subjected to a panel of blood tests and MR scan of the head and neck. All patients had dyspnoea at admission, and five were subjected to a combination of CO(2)-laser excision of supraglottic tissue and closure of the incision with sutures. All serological tests were negative or normal, including angiotensin 1 converting enzyme. The clinical expression was uniform with pale, smooth swellings of the supraglottic structures. Surgery proved successful to maintain normal breathing. None of the many parameters examined--some previously having been found to be abnormal in sarcoidosis--were abnormal in the present cohort. We are therefore unable to elucidate the pathogenesis. The combined surgical approach re-established normal airway function for all five patients and complete remission without further swellings was seen in two patients.
喉结节病罕见（结节病患者的 0.5%），其发病机制尚不清楚，最佳治疗方法仍存在争议。我们进行这项研究旨在阐明临床孤立性喉结节病的可能发病因素，并描述会厌成形术的结果。1995 年至 2009 年，我们在 Rigshospitalet 确定了 6 例经组织学证实的喉结节病患者。所有患者均接受了一系列血液检查和头颈部磁共振扫描。所有患者入院时均有呼吸困难，5 例患者接受了 CO(2)-激光切除会厌上组织和缝线闭合切口的联合治疗。所有血清学检查均为阴性或正常，包括血管紧张素 1 转换酶。临床表现一致，会厌上结构呈苍白、光滑的肿胀。手术成功地维持了正常呼吸。目前这组患者中没有任何参数异常，其中一些先前在结节病中发现异常。因此，我们无法阐明发病机制。联合手术方法为所有 5 例患者重新建立了正常的气道功能，其中 2 例患者完全缓解，未见进一步肿胀。
