Awad Rehab, Shamil Eamon, Aymat-Torrente Antonio, Gibbins Nicholas, Harris Sara
Multidisciplinary Voice Service, Speech and Language Therapy Department, University Hospital Lewisham, Lewisham High Street, London, SE13 6LH, UK.
Kasr Al-Aini Hospital, Cairo University, Cairo, Egypt.
Eur Arch Otorhinolaryngol. 2019 Mar;276(3):793-800. doi: 10.1007/s00405-019-05354-3. Epub 2019 Feb 23.
Recurrent respiratory papillomatosis is a disease caused by the human papilloma virus (HPV). HPV is frequently localised in the larynx. The disease tends to recur and frequent intervention is usually required. Management modules include surgical intervention using microdebriders or laser ablation as well as adjuvant treatments which aim mainly at maintaining an adequate airway and secondly to manage dysphonia caused by the growth on the vocal folds. In this pilot study, another surgical modality is trialled using plasma-mediated radio-frequency ablation (coblation).
Retrospective study examining management of 15 adult patients diagnosed with recurrent laryngeal papillomatosis and surgically treated using coblation. One patient required multiple procedures. Pre-operative assessment in voice clinic evaluating voice quality and its impact on patients' life-quality using voice parameters and self-assessment questionnaires. Follow-up post-operatively using the same parameters from 4 to 6 weeks after surgery until up to 2 years later to check recurrence rate. No other adjuvant treatment was used and all patients received post-operative voice therapy.
78.6% of patients did not show evidence of recurrence during the study period. Improvement in voice handicap following first intervention is reported and recurrence rate in the rest of the sample reported.
The results of this small sample seem to support the previous small studies' findings that coblation is a good excisional technique to use for removal of laryngeal papillomatosis. Recurrence rates seem to be slightly lower than rates reported in the literature for the other surgical modalities.
IV.
复发性呼吸道乳头状瘤病是一种由人乳头瘤病毒（HPV）引起的疾病。HPV常定位于喉部。该疾病易于复发，通常需要频繁干预。治疗模式包括使用微型清创器或激光消融的手术干预以及辅助治疗，辅助治疗主要旨在维持足够的气道，其次是处理由声带肿物引起的发声困难。在这项前瞻性研究中，尝试了另一种手术方式，即使用等离子体介导的射频消融（低温等离子消融术）。
回顾性研究15例被诊断为复发性喉乳头状瘤病并接受低温等离子消融术治疗的成年患者的治疗情况。1例患者需要多次手术。在嗓音门诊进行术前评估，使用嗓音参数和自我评估问卷评估嗓音质量及其对患者生活质量的影响。术后随访，在术后4至6周直至2年后使用相同参数检查复发率。未使用其他辅助治疗，所有患者均接受术后嗓音治疗。
78.6%的患者在研究期间未显示复发迹象。报告了首次干预后嗓音障碍的改善情况以及其余样本的复发率。
这个小样本的结果似乎支持之前小型研究的发现，即低温等离子消融术是用于切除喉乳头状瘤病的一种良好切除技术。复发率似乎略低于文献中报道的其他手术方式的复发率。
IV级。
