Department of Otorhinolaryngology-Head & Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
JAMA Otolaryngol Head Neck Surg. 2014 May;140(5):448-52. doi: 10.1001/jamaoto.2014.243.
IMPORTANCE Classically, surgery has been the mainstay of management for vocal fold (VF) polyps. However, a significant portion of patients experience spontaneous regression and may not require surgery. OBJECTIVES To report the results of conservative management for VF polyps, identify patients with polyps that are more likely to resolve, and describe the time course of resolution. DESIGN, SETTING, AND PARTICIPANTS In this case series of 248 patients with VF polyps conducted presenting to a tertiary referral center, 94 patients were treated conservatively with at least 3 months of follow-up. All laryngoscopy photodocumentation and medical records were reviewed retrospectively. INTERVENTIONS Conservative management with close follow-up. MAIN OUTCOMES AND MEASURES Time course and resolution of VF polyps. RESULTS Of 94 VF polyps, 43 (46%) showed a clinically significant reduction in size, and 36 (38%) resolved completely without requiring surgery. Multivariate analysis showed that VF polyps were most likely to resolve in female patients and in those with small-sized polyp and shorter symptom duration. Of the resolved polyps, 44% and 81% were resolved at 3 months and 8 months, respectively. CONCLUSIONS AND RELEVANCE Selected patients with VF polyp may benefit from conservative management, especially female patients and those with small, recent-onset polyps. The majority of polyps that resolve do so within 8 months, which can assist clinical decision making and counseling.
传统上，手术一直是声带息肉（VF）管理的主要手段。然而，很大一部分患者会自发消退，可能不需要手术。目的：报告保守治疗 VF 息肉的结果，确定更有可能消退的息肉患者，并描述消退的时间过程。设计、地点和参与者：在这项对三级转诊中心就诊的 248 例 VF 息肉患者的病例系列研究中，94 例患者接受了至少 3 个月随访的保守治疗。回顾性审查了所有喉镜摄影记录和病历。干预措施：密切随访的保守治疗。主要结果和措施：VF 息肉的时间过程和消退。结果：94 个 VF 息肉中，43 个（46%）大小有临床显著缩小，36 个（38%）完全消退，无需手术。多变量分析表明，女性患者和息肉较小、症状持续时间较短的患者更有可能消退。在消退的息肉中，分别有 44%和 81%在 3 个月和 8 个月时消退。结论和相关性：选择的 VF 息肉患者可能受益于保守治疗，尤其是女性患者和那些息肉较小、近期发病的患者。大多数消退的息肉在 8 个月内消退，这可以协助临床决策制定和咨询。
