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声门下累及是喉淀粉样变性复发的独立危险因素。

The subglottic involvement is an independent risk factor for recurrence of laryngeal amyloidosis.

机构信息

Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiao Tong University, No. 157 Xi-Wu Road, Xi'an, 710004, Shannxi, China.

出版信息

Eur Arch Otorhinolaryngol. 2023 Nov;280(11):5003-5009. doi: 10.1007/s00405-023-08150-2. Epub 2023 Jul 29.

Abstract

OBJECTIVE

To analyze the risk factors for recurrence of laryngeal amyloidosis (LA).

METHODS

The clinical data of patients with LA admitted in the Otolaryngology Head and Neck Surgery Department of the Second Affiliated Hospital of Xi'an Jiaotong University from August 2009 to June 2022 were analyzed retrospectively; then, the risk factors for recurrence and their impacts on the recurrence time were also analyzed.

RESULTS

Of the 44 patients with LA, the majority (38 cases, 86.4%) only involved one anatomical region and the others (6 cases, 13.6%) involved two laryngeal regions concurrently. Overall, the glottic region was the most commonly affected area (28 cases, 63.6%), followed by the supraglottic region (16 cases, 36.4%) and subglottic region (6 cases, 13.6%). In addition, all the lesions were categorized as isolated nodule (31.8%), submucosal localized deposition (52.3%), and submucosal diffuse deposition (15.9%) according to their morphologies under electronic laryngoscope. Finally, six patients (13.6%) had recurrence after operation with a median recurrence time of 24.5 months, and subglottic involvement was confirmed to be an independent risk factor for recurrence of LA by univariate and multivariate logistic regression analyses (P < 0.05). Meanwhile, the patients with subglottic involvement presented as submucosal diffuse deposition had a considerable shorter recurrence time (t = 5.759, P = 0.005).

CONCLUSION

The subglottic involvement is an independent risk factor for recurrence of LA.

摘要

目的

分析喉淀粉样变(LA)复发的危险因素。

方法

回顾性分析 2009 年 8 月至 2022 年 6 月西安交通大学第二附属医院耳鼻咽喉头颈外科收治的 LA 患者的临床资料,分析其复发的危险因素及其对复发时间的影响。

结果

44 例 LA 患者中,大部分(38 例,86.4%)仅累及一个解剖部位,其余 6 例(13.6%)同时累及两个喉部区域。总体而言,声门区是最常受累的区域(28 例,63.6%),其次是声门上区(16 例,36.4%)和声门下区(6 例,13.6%)。此外,根据电子喉镜下的形态,所有病变均分为孤立性结节(31.8%)、黏膜下局限性沉积(52.3%)和黏膜下弥漫性沉积(15.9%)。最后,6 例(13.6%)患者术后复发,中位复发时间为 24.5 个月,单因素和多因素 logistic 回归分析均证实声门下受累是 LA 复发的独立危险因素(P<0.05)。同时,声门下受累表现为黏膜下弥漫性沉积的患者复发时间较短(t=5.759,P=0.005)。

结论

声门下受累是 LA 复发的独立危险因素。

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