Remacle M, Degols J C, Delos M
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Louvain at Mont-Godinne, Yvoir, Belgium.
Acta Otorhinolaryngol Belg. 1996;50(4):253-64.
Few anatomopathological criteria for distinguishing vocal nodules, polyps or REINKE's edema have been established in previously published studies. In order to study this issue, 163 samples (from 119 patients) were examined by an experienced anatomopathologist, without her prior knowledge of the macroscopic or microscopic diagnosis. In all the cases, the presence of exudative phenomena in REINKE's space proved to be the determining factors, with four outstanding stages of evolution: edema, fibrosis, deposits of fibrin and development of vascular ectasia. Although each of the three entities were seen to have their specific characteristics, a large number of lesions showed histological features which were not very specific, and were dominated by edema. Furthermore, the coexistence of different anatomopathological features makes each group heterogeneous. We propose a model which groups all the exudative lesions of REINKE's space by insisting, on the one hand, on the evolution of the anomalies and, on the other hand, the etiological factors (vocal misuse, tobacco, alcohol acute, vocal trauma ...) which determine the onset of either one or other lesion.
在先前发表的研究中,几乎没有建立区分声带小结、息肉或任克氏水肿的解剖病理学标准。为了研究这个问题,一位经验丰富的解剖病理学家对163个样本(来自119名患者)进行了检查,她事先并不知晓宏观或微观诊断结果。在所有病例中,任克氏间隙出现渗出现象被证明是决定性因素,有四个明显的演变阶段:水肿、纤维化、纤维蛋白沉积和血管扩张的发展。尽管这三种病变都有其特定特征,但大量病变显示出的组织学特征并非非常特异,且以水肿为主。此外,不同解剖病理学特征的共存使每个组都具有异质性。我们提出了一个模型,该模型一方面根据异常情况的演变,另一方面根据决定一种或另一种病变发生的病因因素(发声不当、烟草、酒精、急性发声创伤……)对任克氏间隙的所有渗出性病变进行分组。