Patrial Maria Theresa Costa Ramos de Oliveira, Hamerschmidt Rogério, Matias Jorge Eduardo Fouto, Filho Evaldo Dacheux de Macedo, Carvalho Bettina
Department of Surgical Clinics, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
Int Arch Otorhinolaryngol. 2020 Nov 30;25(4):e496-e503. doi: 10.1055/s-0040-1718529. eCollection 2021 Oct.
The study of larynx lesions is of great importance. More than 50% of people with vocal complaints have benign vocal fold alterations and some require surgery. To determine which factors are related to surgical recurrence of benign laryngeal lesions and to determine which videolaryngoscopic diagnoses are related to the risk or protection of surgical relapses over time. Observational, analytical, cross-sectional study with retrospective data collection of 1,383 surgeries in 1,301 patients. The mean age at the first surgery was 39.2 years old. The predominant gender was female (65.6%). There were 396 cases of polyps (25.34%), 349 cases of cysts (22.33%), 261 cases of Reinke edema (16.7%), 175 cases of nodules (11.2%), 153 cases of minor structural alterations (MSAs) (9.79%), 94 cases of leukoplakia (6.01%), 77 cases of granulomas (4.93%) and 58 cases of pseudocysts (3.71%). The age presented statistical significance with the risk of surgical relapses ( = 0.016). Male gender was associated with the greatest chance of relapse. Diagnosis of granuloma ( < 0.001) and of leukoplakia ( < 0.001) were associated with a higher risk of surgical recurrence. Cyst diagnosis was associated with protection ( = 0.015) in relation to the chance of further surgeries. Patients with associated lesions, bilaterals or voice professionals did not present a statistically significant association with surgical recurrence. Age and gender are statistically related to the increase of surgical relapses. Leukoplakia and granuloma are associated with increased surgical relapses. Patients submitted to cyst microsurgery appear to be protected against surgical recurrence.
喉部病变的研究具有重要意义。超过50%有嗓音问题的人存在良性声带改变，其中一些需要手术治疗。
为了确定哪些因素与良性喉部病变的手术复发相关，并确定哪些电子喉镜诊断与手术复发风险或随着时间推移的复发保护相关。
采用观察性、分析性横断面研究，对1301例患者的1383例手术进行回顾性数据收集。
首次手术时的平均年龄为39.2岁。主要性别为女性（65.6%）。息肉396例（25.34%），囊肿349例（22.33%），任克氏水肿261例（16.7%），小结节175例（11.2%），微小结构改变（MSA）153例（9.79%），白斑94例（6.01%），肉芽肿77例（4.93%），假性囊肿58例（3.71%）。年龄与手术复发风险具有统计学意义（P = 0.016）。男性性别与复发几率最大相关。肉芽肿诊断（P < 0.001）和白斑诊断（P < 0.001）与手术复发风险较高相关。囊肿诊断与再次手术几率的保护相关（P = 0.015）。伴有相关病变、双侧病变或嗓音职业患者与手术复发无统计学显著关联。
年龄和性别与手术复发增加具有统计学相关性。白斑和肉芽肿与手术复发增加相关。接受囊肿显微手术的患者似乎可预防手术复发。
