背景:放线菌病是一种肉芽肿性感染,很少累及喉或咽部。回顾了我们机构的三例喉或咽部放线菌病,并进行了系统的文献回顾,以更好地定义手术治疗。抗生素治疗,危险因素,以及复发或并发症的发生率。
方法:PubMed/Medline,科克伦,Embase,和谷歌学者在2021年11月30日使用术语“喉放线菌病”进行搜索,“咽部放线菌病”,“放线菌病和喉”,放线菌病和咽部。“没有描述适当网站或非英语的文章被排除在外。收集人口统计信息的结果,感染部位,合并症,病变特点和治疗。
结果:加上我们机构报告的三例病例,从37项研究中回顾了40例独特病例,共43例患者(表1)。34例(81.0%)患者为男性,在第七个十年中感染率最高(54.8%)。最常见的感染部位是喉(69.0%),其次是咽(16.7%)。危险因素包括放疗史,免疫抑制,吸入刺激物,和糖尿病(表3)。抗生素治疗的持续时间变化很大,1个月至1年,总随访时间为1个月至2.5年(表1).
结论:对咽喉放线菌病文献的综合回顾表明,这种感染在头颈部癌症患者人群中的患病率增加。类似于颈面部放线菌病,这些非典型部位对延长抗生素治疗表现出良好的反应,通常不需要积极的手术治疗.
BACKGROUND: Actinomycosis is a granulomatous infection that rarely involves the larynx or pharynx. Three cases of actinomycosis of the larynx or pharynx from our institution were reviewed and a systematic literature review was performed to better define surgical management, antibiotic therapy, risk factors, and incidence of recurrence or complications.
METHODS: PubMed/Medline, Cochrane, Embase, and Google Scholar were searched on November 30, 2021 using the terms \"laryngeal actinomycosis\", \"pharyngeal actinomycosis\", \"actinomycosis AND larynx\", and \"actinomycosis AND pharynx.\" Articles which did not describe appropriate sites or were non-English were excluded. Results were collected for demographic information, site(s) of infection, comorbidities, lesion characteristics and treatments.
RESULTS: Along with three cases reported from our institution, 40 unique cases were reviewed from 37 studies for a total of 43 patients (Table 1). 34 (81.0 %) of the patients were male with the highest incidence of infection in the seventh decade (54.8 %). The most common site for the infection was the larynx (69.0 %) followed by the pharynx (16.7 %). Risk factors included a history of radiation therapy, immunosuppression, inhalational irritant, and diabetes (Table 3). The duration of antibiotic therapy varied greatly, from one month to one year and total follow up ranged from 1 month to 2.5 years (Table 1).
CONCLUSIONS: A comprehensive review of the literature on pharyngolaryngeal actinomycosis shows that this infection has increased prevalence within the head and neck cancer patient population. Similar to cervicofacial actinomycosis, these atypical sites have shown favorable responses to extended antibiotic therapy and generally do not require aggressive surgical management.