Chen Min, Chen Jian, Yang Yue, Li Chang-Jiang, Wu Hai-Tao, Chen Lei
Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai, China.
ORL J Otorhinolaryngol Relat Spec. 2018;80(5-6):307-316. doi: 10.1159/000492976. Epub 2018 Sep 11.
To confirm the efficacy of conservative treatment for laryngeal contact granuloma and identify factors influencing treatment outcome.
In this prospective study, patients with laryngeal contact granuloma were divided into a group receiving conservative treatment and a group undergoing surgery. Efficacy was assessed by analyzing the complete response after a 48-week follow-up. The association of treatment outcome with clinical factors was then evaluated.
In total, 61 patients, 43 in the group receiving conservative treatment and 18 in the group undergoing surgery, were analyzed, and the complete response rate was 72.1% and 38.9%, respectively. Both univariate analysis and multivariate analysis revealed that treatment modality (p1 = 0.015, p2 = 0.043), voice abuse (p1 = 0.010, p2 = 0.010), and the size of the granuloma (p1 = 0.031, p2 = 0.020) were significantly associated with the complete response of laryngeal contact granuloma. Kaplan-Meier curves showed that alcohol consumption (p = 0.031), voice abuse (p < 0.001), and granuloma size (p = 0.025) were significantly related to the complete response of conservative treatment.
This prospective study strengthens the argument for conservative treatment (instead of surgery) as the first choice for laryngeal contact granuloma. The results also suggest that voice abuse, alcohol consumption, and the size of the granuloma may predict treatment outcome.
证实喉接触性肉芽肿保守治疗的疗效，并确定影响治疗结果的因素。
在这项前瞻性研究中，喉接触性肉芽肿患者被分为接受保守治疗组和接受手术组。通过分析48周随访后的完全缓解情况评估疗效。然后评估治疗结果与临床因素的相关性。
总共分析了61例患者，其中43例在接受保守治疗组，18例在接受手术组，完全缓解率分别为72.1%和38.9%。单因素分析和多因素分析均显示，治疗方式（p1 = 0.015，p2 = 0.043）、用声不当（p1 = 0.010，p2 = 0.010）和肉芽肿大小（p1 = 0.031，p2 = 0.020）与喉接触性肉芽肿的完全缓解显著相关。Kaplan-Meier曲线显示，饮酒（p = 0.031）、用声不当（p < 0.001）和肉芽肿大小（p = 0.025）与保守治疗的完全缓解显著相关。
这项前瞻性研究支持将保守治疗（而非手术）作为喉接触性肉芽肿的首选治疗方法这一观点。结果还表明，用声不当、饮酒和肉芽肿大小可能预测治疗结果。
