Department of Otolaryngology, Geisinger Health System, Danville, PA, USA.
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale School of Medicine, New Haven, CT, USA.
Am J Otolaryngol. 2022 Sep-Oct;43(5):103550. doi: 10.1016/j.amjoto.2022.103550. Epub 2022 Jul 28.
The larynx is the most common site of localized head and neck amyloidosis. Our study aimed to review the clinical features, treatments, and outcomes associated with localized laryngeal amyloidosis (LA). We also compared these features between two different time periods to evaluate the evolution of LA management.
A literature search using PubMed, CINAHL, Embase, and Cochrane Library identified cases of LA published between 1891 and 2021. Biopsy-proven cases of localized LA were included. Non-English studies, animal studies, and reviews were excluded.
282 patients (1891-1999: 142 patients, 2000-2021: 140 patients) from 129 studies were included. Results are reported as 1891-2000 vs. 2000-2021: Mean age was 48.5 years (range, 8-90 years) vs. 46.0 years (range, 9-84 years). The most common presenting symptoms were dysphonia (n = 30, 95 % vs. n = 127, 96 %) and difficulty breathing (n = 37, 27 % vs. n = 35, 27 %). A total of 62 (44 %) vs. 46 (33 %) lesions were found in the true vocal folds and 35 (25 %) vs. 59 (42 %) were found in the false vocal folds. 133 (94 %) vs. 137 (98 %) patients underwent surgical interventions to investigate and/or treat LA. Recurrent LA was reported in 27 (19 %) vs. 33 (24 %) patients with a mean time to recurrence of 25.4 months (range, 0.3-132 months) vs. 34.5 months (range, 0.8-144 months). Of cases reporting survival rate, 104 (97 %) vs. 107 (99 %) were alive at source study endpoints.
LA typically exhibits an indolent course; therefore, early intervention may address longstanding symptoms. Recurrent disease poses a clinical challenge in patients with LA.
喉是头颈部局限性淀粉样变最常见的部位。本研究旨在回顾与局限性喉淀粉样变（LA）相关的临床特征、治疗方法和结局。我们还比较了这两个不同时期的特征，以评估 LA 治疗的演变。
使用 PubMed、CINAHL、Embase 和 Cochrane Library 进行文献检索，检索 1891 年至 2021 年间发表的 LA 病例。纳入经活检证实的局限性 LA 病例。排除非英语研究、动物研究和综述。
从 129 项研究中纳入了 282 名患者（1891-1999 年：142 名患者，2000-2021 年：140 名患者）。结果报告为 1891-2000 年与 2000-2021 年：平均年龄为 48.5 岁（范围，8-90 岁）与 46.0 岁（范围，9-84 岁）。最常见的首发症状为声嘶（n=30，95% vs. n=127，96%）和呼吸困难（n=37，27% vs. n=35，27%）。62 例（44%）与 46 例（33%）病变位于真声带，35 例（25%）与 59 例（42%）病变位于假声带。133 例（94%）与 137 例（98%）患者接受了手术干预以调查和/或治疗 LA。27 例（19%）与 33 例（24%）患者出现 LA 复发，复发时间平均为 25.4 个月（范围，0.3-132 个月）与 34.5 个月（范围，0.8-144 个月）。在报告生存率的病例中，104 例（97%）与 107 例（99%）在源研究终点时存活。
LA 通常表现为惰性病程；因此，早期干预可能会解决长期存在的症状。LA 患者的复发性疾病带来了临床挑战。
