目的:喉接触性肉芽肿(LCG)是一种相对少见的慢性炎症刺激疾病,长期反流刺激是关节软骨钙化的重要因素。我们的研究比较了同侧关节软骨钙化的严重程度与手术治疗后LCG的复发频率。
方法:回顾性图表回顾了327例患者五年来的前瞻性数据,包括153名没有喉部病变的受试者,是年龄和性别匹配的正常对照,喉部病变组中有103例其他声带病变患者,有71例LCG患者在病理上符合诊断标准。在治疗干预之前,所有受试者均接受了喉部高分辨率计算机断层扫描(HRCT)。术前使用图像数据获得计算机断层扫描(CT)值和关节软骨钙化,并进一步分析其临床意义。
结果:71例LCG患者,包括62名男性,参加了这项研究。在这些案例中,有67例单侧声带病变。在喉部病变组的103名合格患者中,87例单侧病变,其中包括87个人。在153个平均科目中,105人是男性。LCG组的软骨软骨钙化在病变侧明显高于喉部病变和正常组(P<0.01)。此外,LCG患者的CT值(P<0.01)和钙化范围(P<0.01)明显高于喉部病变患者。重要的是,高CT值和病变钙化范围的患者比低CT值和病变面积的患者表现出更大的病变大小和复发率(P<0.01)。
结论:我们的结果表明,大多数LCG患者表现为软骨钙化。软骨软骨钙化越严重,手术治疗后LCG肉芽肿大小和复发的风险越大。关节软骨的CT和骨密度测试可能是评估LCG预后的重要方法。
OBJECTIVE: Laryngeal contact granuloma (LCG) is a relatively uncommon disease with chronic inflammatory stimulation, and long-term reflux irritation is a vital factor for arytenoid cartilage calcification. Our investigation compared the severity of ipsilateral arytenoid cartilage calcification with the frequency of recurrence of LCG after surgical treatment.
METHODS: A retrospective chart review of prospectively gathered data over five years from 327 patients, including 153 subjects without laryngeal lesions, were age- and sex-matched normal controls, 103 patients with various other vocal cord lesions were in the laryngeal lesion group and 71 LCG patients met the diagnostic criteria pathologically. All subjects underwent laryngeal high-resolution computed tomography (HRCT) prior to therapeutic interventions. The computed tomography (CT) value and arytenoid cartilage calcification were obtained using image data before surgery, and their clinical significance was further analyzed.
RESULTS: Seventy-one patients with LCG, including sixty-two males, were enrolled in the study. Among these cases, there were 67 patients with unilateral vocal cord lesions. Of the 103 eligible patients in the laryngeal lesion group, 87 had unilateral lesions, which including eighty-seven men. Of the 153 average subjects, 105 were male. The rate of arytenoid cartilage calcification in the LCG group was dramatically higher in the lesion side than in the laryngeal lesions and normal group (P < 0.01). Furthermore, the CT value (P < 0.01) and range of calcification (P < 0.01) were significantly higher in patients with LCG than in those with laryngeal lesions. Importantly, patients with high CT values and the calcification range of lesions in the arytenoid cartilage displayed a greater lesion size and recurrence rate than patients with low CT values and lesion areas (P < 0.01).
CONCLUSIONS: Our results suggest that most patients with LCG present with calcification of the arytenoid cartilage. The more severe the calcification in the arytenoid cartilage, the greater the risk of granuloma size and recurrence in LCG after surgical treatment. CT and bone density testing of the arytenoid cartilage may be an essential method to evaluate the prognosis of LCG.