Cui Weixin, Xu Wen, Yang Qingwen, Hu Rong
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Ministry of Education, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China.
Eur Arch Otorhinolaryngol. 2017 Feb;274(2):925-929. doi: 10.1007/s00405-016-4298-5. Epub 2016 Sep 14.
Juvenile onset current respiratory papillomatosis (JORRP), which is the commonest benign laryngeal disease in children, has not been well investigated. This study aimed at further evaluating the clinical features and surgery for such children with JORRP. Patients diagnosed as JORRP in our department from January 2011 to June 2014 were enrolled, and the demographic and clinical data were collected. All the patients were followed up after surgery, and the recurrences were recorded. A total of 124 patients were included and categorized into low recurrence (<4/year, n = 97) and high recurrence (≥4/year, n = 27) groups based on the recurrence at diagnosis, respectively. The demographic characteristics were comparable in two groups. There were more patients in high recurrence group who had dyspnea II-III, abnormal chest X-ray findings and severe illness, and needed electrocardiscope monitoring (P < 0.05). Patients who had dyspnea II (P = 0.008) and severe illness (P = 0.002) needed electrocardiscope monitoring (P = 0.014) in high recurrence group were more prone to have recurrence after surgery. Multivariate logistic regression analysis proved that high recurrence at diagnosis was an independent risk factor for recurrence after surgery in JORRP [95 %CI OR 17.342 (1.266, 237.608), P = 0.033]. The recurrence at diagnosis could be used as a prognostic factor for JORRP after surgery, which could help to improve the therapeutic efficacy in such children.
青少年期起病的复发性呼吸道乳头状瘤病(JORRP)是儿童最常见的喉部良性疾病,但目前尚未得到充分研究。本研究旨在进一步评估JORRP患儿的临床特征及手术治疗情况。纳入2011年1月至2014年6月在我科诊断为JORRP的患者,并收集其人口统计学和临床资料。所有患者术后均进行随访,记录复发情况。共纳入124例患者,根据诊断时的复发情况分别分为低复发组(<4次/年,n = 97)和高复发组(≥4次/年,n = 27)。两组的人口统计学特征具有可比性。高复发组中出现Ⅱ - Ⅲ级呼吸困难、胸部X线检查异常及病情严重且需要心电监护的患者更多(P < 0.05)。高复发组中出现Ⅱ级呼吸困难(P = 0.008)、病情严重(P = 0.002)且需要心电监护(P = 0.014)的患者术后更易复发。多因素logistic回归分析证明,诊断时高复发是JORRP术后复发的独立危险因素[95%CI OR 17.342(1.266,237.608),P = 0.033]。诊断时的复发情况可作为JORRP术后的预后因素,有助于提高此类患儿的治疗效果。