Moreddu E, Lambert E, Kacmarynski D, Nicollas R, Triglia J-M, Smith R J
Service d'ORL pédiatrique et chirurgie cervico-faciale, hôpital d'Enfants de La Timone, Aix-Marseille université, 13385 Marseille, France.
Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Feb;136(1):25-28. doi: 10.1016/j.anorl.2018.11.007. Epub 2018 Nov 29.
The study objective was to determine risk factors for severity of juvenile-onset recurrent respiratory papillomatosis (RRP) at first endoscopic evaluation.
Based on a review of all cases undergoing surgery for juvenile-onset RRP in two pediatric otolaryngology departments in the USA and France, the following severity risk factors were analyzed: number of laryngeal levels involved, extension to the subglottis, and bilateral involvement.
Thirty-two patients were included, with 571 endoscopic procedures. Number of endoscopies per patient varied according to initial extension: 30.67 procedures when all three levels were involved, 15.57 procedures when two and 14.08 procedures when only one (P=0.03). The odds ratio for risk of >14 procedures in 3-level involvement was 20.43 (P=0.047). Initial subglottic extension tended to be associated with more endoscopic procedures (23.67 vs 15.56, P=0.16).
RRP severity correlated with initial laryngeal extension of papillomatous lesions at first endoscopy. This finding allowed a short 3-item assessment scale to be created for routine use, complementary to Derkay's assessment scale.
本研究的目的是确定初次内镜评估时青少年复发性呼吸道乳头状瘤病（RRP）严重程度的危险因素。
基于对美国和法国两个儿科耳鼻喉科接受青少年RRP手术的所有病例的回顾，分析了以下严重程度危险因素：受累喉段数量、声门下扩展情况和双侧受累情况。
纳入32例患者，共进行了571次内镜检查。每位患者的内镜检查次数根据初始扩展情况而有所不同：当三个喉段均受累时为30.67次，两个喉段受累时为15.57次，仅一个喉段受累时为14.08次（P=0.03）。三个喉段受累时进行>14次检查的风险比值比为20.43（P=0.047）。初始声门下扩展往往与更多的内镜检查相关（23.67次对15.56次，P=0.16）。
RRP严重程度与初次内镜检查时乳头状瘤病变的初始喉部扩展相关。这一发现使得能够创建一个简短的三项评估量表以供常规使用，作为对德凯评估量表的补充。
