Benedict Peter A, Ruiz Ryan, Yoo MiJin, Verma Avanti, Ahmed Omar H, Wang Binhuan, Dion Gregory R, Voigt Andrew, Merati Albert, Rosen Clark A, Amin Milan R, Branski Ryan C
NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington.
Laryngoscope. 2018 Jan;128(1):138-143. doi: 10.1002/lary.26742. Epub 2017 Jul 17.
OBJECTIVES/HYPOTHESIS: To describe the distribution of recurrent respiratory papillomatosis (RRP) lesions across 21 laryngeal anatomic regions in previously untreated patients at initial presentation to provide insight regarding the natural history of RRP.
Multi-institutional, retrospective case series.
Initial laryngoscopic examination videos of 83 previously untreated patients with adult-onset RRP were reviewed. Papilloma locations were recorded using a 21-region laryngeal schematic. Multivariate analyses by anatomic subsite were conducted for the entire population and for subgroups stratified by sex, age, and proton pump inhibitor (PPI) usage. Heat maps were generated, hierarchically color coding the anatomic distribution of disease.
In this cohort, RRP was most likely to occur on the true vocal folds (TVFs) and anterior commissure (P < .0001, odds ratio [OR]: 7.02); within the TVFs, the membranous vocal folds (MVFs) were most likely to be affected (P < .0001, OR: 3.56). The cohort was predominantly male (80.7%); males had a higher average number of affected sites (P = .005) and were more likely to have lesions in any laryngeal subsite (P < .0001, OR: 2.88,) compared to females. PPI users were more likely than nonusers to have disease in any laryngeal subsite (P = .0037, OR: 1.62), particularly in the posterior and subglottic regions (P = .0061, OR: 2.53). Age was not correlated with lesion prevalence or distribution.
In untreated patients presenting to three laryngology clinics, the MVFs were most likely to be affected by RRP. Males had more anatomic sites affected by papilloma than females. The influence of PPI use on RRP distribution warrants further investigation.
目的/假设：描述初诊时未经治疗的复发性呼吸道乳头状瘤病（RRP）患者的21个喉解剖区域病变分布情况，以深入了解RRP的自然病史。
多机构回顾性病例系列研究。
回顾了83例初诊的成年起病RRP患者的首次喉镜检查视频。使用21区域喉示意图记录乳头状瘤位置。对整个人群以及按性别、年龄和质子泵抑制剂（PPI）使用情况分层的亚组进行解剖亚部位的多变量分析。生成热图，对疾病的解剖分布进行分层颜色编码。
在该队列中，RRP最常发生于真声带（TVF）和前联合处（P <.0001，比值比[OR]：7.02）；在TVF内，膜性声带（MVF）最易受累（P <.0001，OR：3.56）。该队列中男性占主导（80.7%）；与女性相比，男性平均受累部位数量更多（P =.005），且在任何喉亚部位发生病变的可能性更大（P <.0001，OR：2.88）。PPI使用者在任何喉亚部位发生疾病的可能性均高于非使用者（P =.0037，OR：1.62），尤其在后侧和声门下区域（P =.0061，OR：2.53）。年龄与病变患病率或分布无关。
在就诊于三家喉科诊所的未经治疗患者中，MVF最易受RRP影响。男性乳头状瘤累及的解剖部位比女性更多。PPI使用对RRP分布的影响值得进一步研究。
4。《喉镜》，2018年，第128卷，第138 - 143页。
